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Male, 57 years of age, type 2 diabetes. He started with us 6 months ago. When he started seeing us, he was taking  glipizide 10mg twice a day and metformin 1,000 twice daily for his glucose. His A1C was 7.5%, his BMI was 24. We stopped his glipizide and started him on a SGLT-2 and a weekly GLP-1. He met with the dietitian and made some big dietary changes, at least at the start. He also started wearing a CGM and was in our remote monitoring program. He sent me his CGM readings weekly for 4 months. He was doing so well, we decided he need not send me his weekly numbers but rather we’d review during his visits.

In this week's Homerun Slides, we conclude with a look at the future direction of diabetes apps.

The CTLA4 gene on chromosome 2q33.2 encodes a transmembrane co-receptor expressed on the surface of T cells. This functions as a negative regulator of T-cell activation via interaction with the B7 molecule on antigen-presenting cells (Figure 30.3). The G allele of the +49A/G SNP in exon 1 of CTLA4 has been implicated as a susceptibility marker for T1DM, but was rejected as a causal SNP by a fine-mapping study, which showed that its effect could be explained by more strongly associated variants in a 6.1 kb noncoding region, 3′ of the gene.

Only a minority of U.S. adults with prediabetes eligible to participate in a national diabetes prevention program are doing so.

Pioglitazone shown to be effective for secondary prevention in patients who have had a stroke and have prediabetes, according to a post hoc analysis of the IRIS trial.

Women with type 2 diabetes are at increased risk of developing breast cancer.

New evidence suggests added consideration of the protein and fat.

Reusable smart insulin pens to launch first, followed by Bluetooth attachment for disposable pens later in 2019.

While increased cancer risk was not found, overall study of sweeteners vs sugar remains inconclusive.