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Production Assistant, Diabetes In Control

The Insulin Pump Market: A Look Back at 2017 and Ahead to the New Year

By Guest Writer David Kliff, Publisher, Diabetic Investor

As 2018 begins, my attention turns toward a look back at the year gone by and ahead to the year that’s starting. As always, my New Year will begin in that beautiful city by the bay at the JP Morgan Healthcare Conference. This is a conference I suspect will be one of the more interesting, and since I’ve attended nearly 20, that’s saying something. Lots is going on behind the scenes in our wacky world, and given the nature of JPM I suspect the veil of secrecy will be lifted.

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Insulin Biosimilars

Insulin Biosimilars for both long- and short-acting insulins will be available shortly from major insulin suppliers. Will you recommend them if they are at least 20% lower in cost? Follow the link to see what your colleagues say.

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Practice Update

Download the PracticeUpdate app today for FREE, and enjoy all the quality information, expert commentary, and customized content you love in a mobile-friendly package. Expert-selected articles and research. Quit roaming from site to site, and rely on our industry experts to hand-select the top articles, studies, and breaking news from 100s of journals.

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On-the-Go Treatment

A 43-year-old patient presents to your clinic for an appointment. She has mild hypertension, which is currently well controlled with a beta 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 with a most recent FPG of 160 mg/dl. At today’s visit, she has an A1C of 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? 1. Add a basal insulin dose once a day 2. Add pre-mixed insulin twice a day 3. Add pre-mixed insulin twice a day and change her non-insulin medications 4. Add a basal insulin dose once a day and change her non-insulin medications Follow the link for the answer.

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That Time of Year Again: What’s Right For Me?

As a CDE who specializes in obesity medicine and diabetes, I hear many patients with either or both diagnoses say they are ready to get a “new start.” It’s not unusual for patients to change the medications, or even stop the medications, we have agreed on for them, and their numbers go up.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #107: Treatment of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Part 5

Glucose-lowering agents: Metformin is a biguanide that has been used worldwide for more than 50 years for the treatment of T2DM although its exact mechanism of action remains incompletely understood. It decreases hepatic glucose production and improves insulin sensitivity at the level of the liver, and to a lesser extent, muscle. Metformin has been reported to reduce plasma aminotransferase levels in patients with NAFLD. Early small studies suggested that metformin improved hepatic steatosis, necro-inflammation and/or fibrosis in patients with NASH, but not in more recent and better controlled clinical trials.

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Antihyperglycemic Regimen

A 75-year-old man presents to your office with complaints of occasional mild hypoglycemia. His current antihyperglycemic regimen includes metformin and nateglinide. You would like to modify his treatment regimen to minimize his risk of hypoglycemia. Which one of the following 2-drug combinations would NOT be a suitable substitution? A. Metformin + pioglitazone B. Metformin + glipizide C. Metformin + vildaglipitin D. Metformin + exenatide Follow the link for the answer.

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