Monday , November 20 2017

From the Editor

November, 2017

  • 18 November

    Nov. 18, 2017

    We lost one of our first board members last week when Dr. Keith Campbell, Pharmacist, CDE, Professor of Pharmacy at Washington State, passed away at the age of 76. Keith had recently been bestowed the Lifetime Achievement Award from Washington State University. Keith will be missed by the thousands of …

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Latest Articles

November, 2017

Test Your Knowledge

Treating Increased A1C

A 64-year-old female presents to your office for her 3-month follow-up. She has previously been diagnosed with mild diastolic heart failure, secondary to hypertension. She currently takes an ace-inhibitor and a diuretic with good control of her heart failure symptoms and hypertension. At her last visit, she had a FPG 118 mg/dl. In a subsequent conversation with her, you discussed how she has developed prediabetes and suggested lifestyle modifications. Since her last visit, she has taken up very gentle walking four times/week and has changed her diet to a more healthful one. Despite these positive changes, this visit’s labs return an A1C 7.8%; her remaining labs are within normal limits. Which one of the following antihyperglycemic medication classes would you choose to initiate treatment?

Correct

Correct Answer: B. Biguanides

Educational Critique: Metformin would be considered the first-line drug of choice for this patient. The use of metformin in patients with diabetes and heart failure used to be contraindicated (its use in patients with compromised renal function being associated with lactic acidosis). However, it can now be used in select patients with heart failure if renal function is normal, CV status is stable and ventricular dysfunction is not severe. Eurich, et al. (2005) conducted a retrospective analysis of type 2 diabetes patients treated with metformin vs. sulfonylureas and found overall decreased mortality in the metformin group. Masoudi et al (2005) examined metformin vs. thiazolidinediones and found the reduced risk of death at 1-year and lower hospital admission rates in the metformin group, while increased hospital admissions (primarily due to heart failure readmissions) was seen in the thiazolidinedione group. Thiazolidinediones increase renal sodium and water reabsorption, causing fluid retention and worsening of heart failure signs/symptoms. A recent retrospective analysis (Tzoulaki, et al., 2009) found an association between the use of sulfonylureas and increased risk of developing/worsening heart failure. Both classes of drugs should not be used in patients with diabetes and heart failure.

Incorrect

More Articles

November, 2017

  • 18 November

    Treating Comorbidities

    In treating your patients with diabetes who have hypertension, elevated blood sugars, and elevated LDL’s, do you treat 1 or 2 of the comorbidities or all 3 at the same time? Follow the link to share your response.

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  • 18 November

    Mark Huising Current Interview

    Dr. Mark O. Huising completed his formal education in the Netherlands, where he spent his PhD studying the evolution of immune and endocrine systems in early vertebrates.

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  • 18 November

    Mark Huising Transcript

    Mark Huising discusses his ADA symposium on “Neglected Delta Cell: The Difference Delta Cells Make in Glucose Control," and the nature and importance of delta cells in diabetes research.

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  • 18 November

    Mark Huising Full Interview

    In this Exclusive Interview, Dr. Mark Huising talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about his work in delta cells, their impact on the body as well as diabetes, and the importance of imparting an understanding about these cells to the diabetes community, patients and medical professionals alike.

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  • 17 November

    Mark Huising Part 1, The Difference Delta Cells Make in Glucose Control

    In part 1 of this Exclusive Interview, Dr. Mark Huising talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about the function of delta cells and what precipitated his work in this field.

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  • 17 November

    Mark Huising Part 2, Delta Cells Effects on Type 2 Diabetes

    In part 2 of this Exclusive Interview, Dr. Mark Huising talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about the impact of type 2 on delta cells and measuring the activity of these cells.

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  • 17 November

    Mark Huising Part 3, Diabetes Medication Effects on Delta Cells

    In part 3 of this Exclusive Interview, Dr. Mark Huising talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about the impact of diabetes medications on delta cell activity.

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  • 17 November

    Mark Huising Part 4, Delta Cell Research Effect on Diabetes

    In part 4 of this Exclusive Interview, Dr. Mark Huising explains the benefit of his research for those with diabetes, medical professionals, and medical students as well, in a conversation with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California.

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  • 17 November

    Mark Huising Part 5, Final Thoughts

    In part 5, the conclusion of this Exclusive Interview, Dr. Mark Huising talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California about what he's learned from colleagues and the importance of collaboration.

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  • 14 November

    Scare Them or Inspire Them?

    Today, my patient, a woman, 42 years of age, brought her daughter who is 18 years of age with her for her visit. Mother has PCOS, class III obesity and type 2 diabetes. She told me she brought her because of the strong family history of diabetes on both sides of his family. She wanted her to understand what someone who has diabetes goes through.

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  • 14 November

    Aaron Vinik Part 2, Heart Failure and Diabetes

    In part 2 of this Exclusive Interview, Dr. Aaron Vinik talks with Diabetes in Control Publisher Steve Freed during the AACE 2017 convention in Austin, Texas about the work and results of the EMPA-REG and LIRA studies, among others, and the medication that truly is the game changer in the world of diabetes treatment.

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  • 14 November

    Diabetes 2017 Part 1

    In this week's Homerun Slides, we start taking a look at the latest technology and medications to impact diabetes management.

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  • 14 November

    International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #99: Pathogenesis of nonalcoholic fatty liver disease (NAFLD) Part 1

    NAFLD is defined as steatosis (greater than 5–10% of hepatocytes are fatty), which is not due to excess use of alcohol (defined in European and American guidelines as greater than 20 g of alcohol daily for women and greater than 30 g for men), or other conditions as determined by careful family and medical history, and laboratory tests to exclude at least steatosis due to viral and autoimmune causes and iron overload.

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  • 11 November

    Vitamin D’s Role In Preventing Type 1 Diabetes

    Vitamin D supplementation could possibly reduce the risk of type 1 diabetes in susceptible children.

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  • 11 November

    Reduced Sugar Claims Misleading

    Sugar_Sugar

    New study suggests packaged food claims like “reduced in sugar” or “no added sugar” still have sugar levels too high by World Health Organization standards.

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