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Production Assistant, Diabetes In Control

Question #848

Test Your Knowledge

Clinicians treating patients with type 2 diabetes should include lifestyle interventions when developing diabetes management plans. Which of the following is NOT appropriate? 1.Weight reduction, if necessary 2. A minimum of 150 minutes/week of moderate-intensity aerobic physical activity, spread over at least 3 days/week with no more than 2 consecutive days without exercise 3. Diabetes Self-Management Education & Support (DSME/DSMS) 4. A calorie fixed ADA diet 5. Individualized plan of calories including recommended amounts carbohydrates, fats, and proteins Do you have the right answer? Follow the link to find out!

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Diabetic Coach

Would you know what to do in a diabetic seizure emergency situation? There are simple solutions to ensuring you have what it takes to help a family member, co-worker, child, or stranger in need of emergency first aid.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #38: Normal Beta-cell Function Part 3 of 6

Beta-Cell response to nonglucose secretagogues: Proteins and amino acids -- The insulinotropic effect of oral proteins was first described almost 50 years ago and recently confirmed. After the ingestion of a small amount of proteins (30–50 g) or a larger amount of proteins (2 g kg−1), plasma insulin was raised two- to threefold over baseline and remained persistently elevated for 90 or 240 minutes, respectively. In either case, blood glucose did not change, whereas both GLP-1 and GIP levels were raised threefold over fasting values.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #37: Normal Beta-cell Function Part 2 of 6

Beta-Cell response to intravenous glucose: Although in normal living conditions beta cells are stimulated by hyperglycemia that follows glucose ingestion, the study of the response to intravenous glucose is of fundamental importance for understanding the physiology of beta cells. Several tests have been developed for this purpose and this section describes the most relevant and the characteristics of insulin secretion that they reveal.

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Ghost Pills

When it comes to metformin, when appropriate, I recommend the extended release version. Last week my patient, female, 56 years of age, type 2 diabetes, visited. A1C was elevated, and she gained 5 pounds. She had been on metformin ER for the last 6 months and doing well. She said she recently noticed a bean-looking/pill-looking thing in her stools that seemed to be related to her metformin.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #35: Beta-Cell biology of insulin secretion Part 5 of 5

Autocrine effect of insulin on insulin secretion: Rodent and human pancreatic beta cells possess the various components of the insulin signaling system, including insulin receptor, insulin-like growth factor-1 (IGF-1) receptor, insulin receptor substrates (IRS-1 and IRS-2), phosphatidylinositol 3-kinase (PI3K), phosphoinositide-dependent kinase-1 (PDK1), and protein kinase B (PKB)/Akt. It has been shown that insulin binds to the insulin receptors on the surface of beta cells and induces phosphorylation of the insulin receptors and IRSs,modulating its own secretion. This effect of insulin is involved especially in the 1st phase of GIIS in mice.

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Sometimes it Takes a Human

63-year-old male, moderate cognitive impairment and lives alone. Patient lost a significant amount of weight, frequent symptomatic hypoglycemia, including light-headedness and dizziness, requiring lowering and stopping some of his glucose lowering medications. GLP-1 was stopped and his glucose levels were in normal range. We were very clear that he should not resume his GLP-1 until we saw him again.

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