Tuesday , December 1 2015

From the Editor

November, 2015

  • 25 November

    November 28, 2015

    Those of us in the U.S. celebrated Thanksgiving this week. One of the things the DIC team has to be thankful for is our wonderful readers. We’re grateful for your loyal readership and especially for the great feedback and content, like our weekly Disasters Averted stories, you send us. We ...

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Latest Articles

November, 2015

  • 30 November

    Practical Diabetes Care, 3rd Ed., Excerpt #40: Psychological Aspects of Diabetes Part 4 of 4


    In the Look AHEAD study, about 15% had symptoms of mild–moderate depression, about 17% were current users of antidepressant medication, and about 4% both [13]. Other studies in the USA have described higher rates, up to 25%, of more severe depression, with all ethnic groups (white, African-American, Latinos and others) recording similar rates.

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  • 30 November

    The Present and Future of Insulin Therapy Part 18


    In this week's Homerun Slides, the effect of dapagliflozin on endogenous glucose production, plasma insulin and glucagon concentration.

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  • 30 November

    Dr. Richard Bergman, Part 1 – Measuring Insulin Resistance


    Diabetes in Control Publisher Steve Freed meets with Dr. Richard Bergman at the 75th ADA Scientific Sessions in Boston. In this first installment, Dr. Bergman shares his start in diabetes research and explains the high points of his presentation, Comparative Methods for Assessment of Insulin Sensitivity: Oral Vs. Intravenous. Dr. Richard Bergman is the founder and director of Diabetes and Obesity Research Institute, Biomedical Sciences at Cedars-Sinai in Los Angeles. He introduced the use of engineering principles to understand the pathogenesis of diabetes.

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  • 30 November

    Sometimes Long-term Patient/Healthcare Provider Relationship Must Be Severed

    Nurse caring about elder man

    I am a primary care provider in a small private office. A long-term patient of mine, 32 years of age, was recently diagnosed with type 1 diabetes. His insurance is now one I do not participate in. Until his recent diagnosis, he visited annually and paid out of pocket. He wanted to stay with me for his care. I realized his needs were most likely more than he could afford.

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  • 28 November

    Best Ideas for Preventing Insulin Errors from the DIC Community


    Diabetes In Control readers submitted their best advice on how to prevent insulin errors at home, at pharmacies, and in the hospital. We're happy to present the winning entry, by Joyce Larson, as well as a selection of other excellent entries.

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Test Your Knowledge

Question #809

43-year old patient presents to your clinic for an appointment. She has mild hypertension, which is currently well controlled with a ß-blocker. She was diagnosed with type 2 diabetes 6-years ago, and has been taking metformin and glipizide. She has noticed that her recent self-blood glucose monitoring numbers have been creeping up and with a most recent FPG of 160 mg/dl. At today’s visit, she has an A1C 8.0%. She tells you that until now her job has required she travel several times a month. This week she was promoted to a managerial position that does not require travel. Which of the following approaches would be the best for her?


Answer A

Usually, the addition of basal insulin is considered the optimal initial insulin regimen; usually in conjunction with one or two noninsulin agents. Generally, therapeutic regimens should begin with some basal insulin before moving to more complex insulin strategies. Starting a pre-mixed insulin regimen as the initial insulin strategy can be considered in patients willing to take more than one injection a day and with higher A1C level (>9.0%). Pre-mixed regimens tend to lower A1C slightly more when compared to basal insulin alone. However, the use of pre-mixed insulin can lead to slightly more hypoglycemia and weight gain than basal insulin. When basal insulin is used, the continued use of secretagogues may provide some benefit in reducing initial glycemic control deterioration. However, with the addition of prandial insulin, while metformin is usually continued and may help prevent some weight gain, secretagogues should be stopped.. In addition to continued general diabetes education (SBGM, lifestyle modifications, disease course), patients should receive education on the avoidance, recognition and treatment of hypoglycemia.


Inzucchi S, et al. Management of hyperglycemia in type 2 diabetes: A patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2012; 35(6):1364-1379.


And don’t forget to visit our Test Your Knowledge retrospective – click here to view the 5 most popular questions of 2015!

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November, 2015