Mr. Carlson is 52-year old Caucasian grocery store manager you saw last week for a new patient visit. His labs from that visit were significant for elevated random plasma glucose 166 mg/dL, A1C 7.4% and elevated lipids (TG equals 175 mg/dL, LDL 148 mg/dL, HDL 38 mg/dL, total cholesterol 221 mg/dL). He has returned to your clinic for a follow-up appointment. His physical exam is notable for central abdominal obesity (waist circumference 42”),left eyelid xanthelasma, BP 147/91, HR 72, RR 18, BMI 36 kg/m2, but otherwise normal. A repeat A1C test shows A1C 7.6% Mr. Carlson smokes between 1 and 1.5 packs of cigarettes daily. After discussing the labs and your findings with Mr. Carlson, you begin collaborating on a management plan. You write prescriptions for metformin, a statin and ACE inhibitor. Mr. Carlson doesn’t think “taking medication will be too tough” but expresses skepticism about your recommendations for a change in his diet, exercise and smoking programs because he has tried them, without success in the past. What is considered the starting BMI for consideration of bariatric surgery? 1. BMI greater than 28 kg/m2 2. BMI greater than 30 kg/m2 3. BMI greater than 35 kg/m2 4. BMI greater than 37 kg/m2 Follow the link for the answer.

The American College of Physicians (ACP) has issued a new recommendation that type 2 patients should not have a target A1C level below 8 percent for any patient population and should not have any A1C targets for older adults (e.g., age 80 and older) or younger individuals with limited life expectancy because of other serious diseases and illnesses. Do you agree with the American College of Physicians' new A1C target recommendations? Follow the link to share your opinion.

Both patients with diabetes and health care professionals expect wider adoption of continuous glucose management systems in the future for patients with type 2 as well as type 1, and agree that cost is a key factor in patient choices

In part 1 of this 2-part Exclusive Interview, Angela Golden talks with Diabetes in Control Publisher Steve Freed during the AACE 2017 convention in Austin Texas about obesity in people over the age of 65.

The suggested hierarchy of usage (AACE Algorithm) for a patient on metformin who has not reached goal according to the new 2018 AACE goal in 3 months is: A. GLP-1RA, SGLT-2i, TZD, Basal Insulin, DPP4i B. SGLT-2i, GLP-1RA, TZD. DPP4i, Basal Insulin C. GLP-IRA, DPP4i, GLP-1RA, Bromocriptine QR D. SGLT-2i, TZD, GLP-1RA, Colesevelem E. SGLT-21, GLP-1RA, Basal Insulin, Colesevelem Follow the link for the answer.

What percentage of time do you recommend a sulfonylurea because that is what the patient can afford? Follow the link to see how you compare to your colleagues.

2017 was book-ended by the ADA: the new 2017 guidelines were the most popular article in January, and in December the 2018 guidelines took center stage. Please take a look back with us at everything that happened in between. We thank you for your readership this year, and look forward to sharing the important diabetes news of 2018.

In 2017, we offered weekly survey questions on topics ranging from standard tests, to new drugs, to opinions on CGMs, to personal exercise habits - and you answered. Here are the survey questions that drew the most response this year.

Can you name the one most-viewed DIC article in 2017? Your choices are: a) Health Benefits from Intermittent Fasting b) 1-Hour Post-Prandial Glucose Predicts Risk For Type 2 Diabetes c) New ADA 2017 Standards d) Type 1 Cured in Mice e)The Future For Insulin Pump Companies: Who Will Survive? Follow the link to see the correct answer!

The community services that the Medical Fitness Network provides will allow people with diabetes to select a knowledgeable team of fitness and wellness professionals to help improve and maintain their well-being over a lifetime.