Monday , January 22 2018

From the Editor

January, 2018

  • 20 January

    Jan 20, 2018

    We have continued to add new and more effective medications for diabetes focusing on different defects in metabolism. These additions have actually put the drugs in the weird position of competing with each other and working together at the same time. This week, our newsletter is full of examples of …

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Latest Articles

January, 2018

Test Your Knowledge

Insulin Therapy Barriers

A 51-year-old patient returns to your office for a follow-up visit. She is currently taking metformin and glipizide after being diagnosed with type 2 diabetes 8 years ago. She shows you her self-care logs that indicate she has been eating a healthy diet and walking daily. She has been maintaining her weight (BMI 26kg/m2). Despite her excellent efforts, her A1C is 7.8%, above her target of A1C<7.0%. When you start to discuss adding a basal insulin dose to her regimen, she bursts into tears. All of the following are common barriers to insulin therapy initiations EXCEPT:

Correct

Correct Answer:  A. Fear that hyperglycemia will make her ill

Educational Critique: Common patient-identified barriers to initiating insulin therapy are: fear others will see them differently; insulin is not an effective treatment for diabetes; using insulin can lead to complications or death; concern that using insulin will negatively impact their lifestyle; fear of hypoglycemia: fear of weight gain; fear of needles of injection pain; and insulin cost concerns. Fear of hypoglycemia can be ameliorated with choosing insulin less likely to cause hypoglycemia (newer rapid-acting and longer-acting analogue insulins) as well as patient education on the frequency, avoidance, recognition and treatment of hypoglycemia.

Sources:

Patient. 2014; 7(4): 437–450.  Published online 2014 Jun 24. doi:  10.1007/s40271-014-0068-x

Diabetes Care. 2010 Apr; 33(4): 733–735.  Published online 2010 Jan 19. doi:  10.2337/dc09-1184

Incorrect

More Articles

January, 2018

  • 20 January

    Stroke and Dementia Risks With Sugars and Artificial Sweeteners: Fact or Fiction?

    Researchers use data from large ongoing cohort study to look for connection. In a recent study, researchers concluded that sugar and artificially sweetened beverage intake have been linked to cardiometabolic risk factors, which increase the risk of cerebrovascular disease and dementia. The study examined whether sugar or artificially sweetened beverage …

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  • 20 January

    CGM Preference

    Which CGM system do you prefer? 1) Dexcom C5 2) Abbott Freestyle Libre 3) Medtronic Elite 4) Either 5) None Follow the link to see how you and your colleagues compare.

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  • 20 January

    Mark Peyrot Current Interview

    Mark Peyrot is Professor of Sociology at Loyola University Maryland and Professor of Health and Social Sciences at Bergen University College (Norway). He formerly was a faculty member in the departments of Sociology and Medicine at the University of Kentucky and Medicine at Johns Hopkins University.

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  • 20 January

    Mark Peyrot Transcript

    In this Exclusive Interview, Mark Peyrot talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, CA about the importance of addressing the psychosocial needs of diabetes patients.

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  • 20 January

    Mark Peyrot Full Interview

    In this Exclusive Interview, Mark Peyrot talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, CA about the importance of addressing the psychosocial needs of diabetes patients.

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  • 16 January

    Mark Peyrot Part 1, Psychology Of Diabetes

    In part 1 of this Exclusive Interview, Mark Peyrot talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, CA about his work in the field of behavioral diabetes research.

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  • 16 January

    Mark Peyrot Part 2, Psycho-Social Diabetes Guidelines

    In part 2 of this Exclusive Interview, Mark Peyrot explains the ADA psycho-social guidelines in a conversation with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, CA.

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  • 16 January

    Mark Peyrot Part 3, Key Recommendations for Psycho-Social Diabetes Guidelines

    In part 3 of this Exclusive Interview, Mark Peyrot talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, CA about the key facets to the guidelines and how healthcare providers can use them to help in the care of their patients.

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  • 16 January

    Mark Peyrot Part 4, Implementing Psycho-Social Diabetes Guidelines

    In part 4 of this Exclusive Interview, Mark Peyrot talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, CA about ways healthcare providers can effectively implement these guidelines into their busy appointments with their patients.

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  • 16 January

    Mark Peyrot Part 5, Takeaways from ADA Psycho-Social Diabetes Guidelines

    In part 5 of this Exclusive Interview, Mark Peyrot talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, CA about the importance of talking with their patients to assess the state of their feelings about their diabetes management.

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  • 16 January

    A Way to Motivate Unmotivated Patients

    Young man, 21 years of age. type 1 diabetes since 9 years of age. Has not been to see hcp for a year. States he doesn’t like people interrogating him, but came in because he needs his insulin. States he doesn’t check his glucose because he can tell what it is. Tired of having type 1 diabetes and tired of checking numbers. A1C in office--10.2%.

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  • 16 January

    Ray Kausik Part 3, PCSK9 Effect On Lowering Cardiovascular Death

    In part 3 of this Exclusive Interview, Dr. Ray Kausik talks with Diabetes in Control Publisher Steve Freed during the ADA 2017 convention in San Diego, CA about work toward lowering the risk of cardiovascular death.

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  • 16 January

    Framework for Understanding DM Part 4

    In this week's Homerun Slides, the genetics of diabetes and the implications for beta cells.

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  • 16 January

    International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #108: Type 2 Diabetes and Cancer Part 1

    Introduction: An association between hyperglycemia, diabetes, and cancer has been recognized for many years. Epidemiologists first noted the association between diabetes and cancer in the early part of the twentieth century, while the association between hyperglycemia and cancer was reported in 1885. At that time, in Europe and North America life expectancy was improving, rates of over-nutrition and under-exercise were increasing, there was a rise in the percentage of people that were overweight, and the incidence of diabetes began to climb.

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  • 13 January

    How To Overcome The Complexities of Treatment Decisions For Your Type 2 Diabetes Patients

    Part 1 of a four part series on a framework developed by Dr. Bradley Eilerman and Len Testa for recommending medications for treating patients with type 2 diabetes.

    A thousand times today, in offices all over America, hospital patients will be diagnosed with type 2 diabetes. When that happens, a healthcare provider has to make a treatment decision of enormous complexity, often with partial information to go on, and in the span of just a few minutes.

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