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Letter From The Editor

Letter from the Editor, #778

In the state of Florida there is a law in the statehouse to give drug prescribing privileges to Nurse Practitioners and Physician Assistants. Supporters of the bill say there is an acute shortage of prescribers in many areas which prevents patients...


Editor's Note, DCMS #237

Over the past few weeks Dr. Stanley Schwartz has been looking at the causes and reasons that insulin resistance and hyperinsulinemia go crazy when a patient develops diabetes. This week, in the last part of the series, he brings to light the use of...


GLP-1 Agonists, Special Edition, April 2015

Last week we had a 56 y/o female patient who worked for the county schools as a bus driver. She has less than a year till retirement and was worried because she might lose her job because of her elevated A1c. She has had diabetes for 12 years and...



Letter from the Editor, #777

CMS just rolled out the new five-star ratings for hospitals and the results are less than stunning. Out of 3,500 hospitals, twice as many hospitals received one or two stars as those receiving five stars. The new ratings are part of a broader...


Editor's Note, DCMS #236

On Monday I was in Kentucky visiting my sister and my dad, and I rented a bike for a couple of days' riding. When I told one of my sister's friends that I would probably ride about 30-40 miles each day she looked at me and said, "You don't...


Letter from the Editor, #776

Have you ever had your patients tell you that they only eat small servings and they are never hungry? I find it interesting that obese patients will suddenly swear that they are eating less just because we tell them to. They had to have had that...


Editor's Note, DCMS #235

The research is unclear on whether diabetes increases the risk of bad infections or bad infections cause worsening glucose levels. I think that both are true but, regardless of your opinion, the important things are to treat aggressively and try to...


Letter from the Editor, #775

It is amazing how things have changed in the way we work with diabetes patients. In the office this week I was seeing some patients for individual counseling, and as we were talking about food choices I kept hearing one comment over and over: "This...


Editor's Note, DCMS #234

"Heloderma suspectum" is the buzz phrase this week. It turns out that he is a cousin of Martin, the green lizard of Geico fame, and was the first reptile to make using incretins in diabetes therapy possible. This class has changed the...


Letter from the Editor, #774

It is time to get out your wallets and take out the big bills that you have hiding in the back. Why do you need to do this? Because the cost of poor diabetes care is growing larger every day. For years we have known that patients with diabetes...


Editor's Note, DCMS #233

About a year ago one of my pharmacist colleagues called me and was complaining about his blood glucose levels. At the age of 37 he had developed diabetes and was placed on metformin. His glucose improved and he went on a wellness program. After...


Editor's Note, SGLT-2 Inhibitor Special Edition, March 2015

It has been two years since the first SGLT-2 inhibitor, canaglifozin, was approved by the FDA. Since that approval, two more drugs in this class have been approved and the acceptance and use by medical professionals has widened. The mechanism of...


Letter from the Editor, #773

The most frequently asked questions in our diabetes classes have to do with drinking sodas. This usually occurs when we are talking about carbohydrate counting. The comments made usually revolves around artificial sweeteners and cancer or that...


Editor's Note, DCMS #232

Last week in our main newsletter we shared our latest one-page handout for helping diabetes patient with food recommendations....


Letter from the Editor, #772

Thirty grams of protein seems to be the magic number for breakfast as seen in this week's Item #1, when we are talking about improving glucose levels and...


GLP-1 Analogs Special Edition, March 2015

We are rapidly approaching the ten year anniversary of the entrance of GLP-1 analogs into the diabetes marketplace. It all started with exenatide and most medical professionals we interviewed back then did not believe that clinicians or patients...


Editor's Note, DCMS #231

We have always been very focused here at Diabetes in Control on the value of physical activity for the prevention of diabetes and reduction of obesity. We offer apps for your patients and we even have our own physical activity guru, Dr....


Letter from the Editor, #771

Novo spent a lot of time on studies and research on liraglutide as a weight loss product. Saxenda was approved in December 2014, and they are starting to gain market traction. The question comes to mind -- if you give a diabetes drug to an non- or...


Editor's Note, DCMS #230

We often take insulin for granted and reach in the fridge to start a patient on this drug without a lot of hesitation. But have you ever considered what it takes to make insulin, or how subtle differences in production can have big...


Letter from the Editor, #770

We all know the definition of insanity is "doing the same thing over and over again and expecting the same results." Nowhere has this been more true than in medicine. Thirty-five years ago, the...


Editor's Note, DCMS #229

This week's Clinical Mastery Series newsletter is chock full of great information to help with your patients. First we wrap up


Letter from the Editor, #769

No matter how you want to analyze it there is an impeding explosion in diabetes care and also in how much it will cost. Part of this is addressed by paying clinicians to deliver patient interactions via the internet. Although early studies seem to...


Editor's Note, DCMS #228

Have you had patients come to your office with the latest and greatest thing for "curing" diabetes? Not a day goes by without someone showing me a new way to lose weight and fix their diabetes. But the real question is, are these fixes...


Letter from the Editor, #768

When we do a diabetes education program for patients we always talk about food choices. The overwhelming key to success is not to give people impossible goals to follow and try to restrict everything they can have. Having them cut portions down too...


Editor's Note, DCMS #227

Ten years ago when a patient checked into the hospital for severe hypo- or hyperglycemia we took the attitude that if we could get them back to normal and get them home then our job was done. That was before we knew


Letter from the Editor, #767

I was working in the pharmacy and my technician attempted to process a prescription for a 71 y/o patient for glyburide 5 mg. The claim kept rejecting as "drug not covered, prior authorization requested." This...


Editor's Note, DCMS #226

Today I was working with two patients to convert them from sliding scale and mixed insulin to basal/bolus dosing. As I was going over the reasons for making the change and the...


Letter from the Editor, #766

When we see older men with diabetes in the office we often see the change in muscle mass and our first thought is to check testosterone levels. For many of these seniors the levels are acceptable and we just attribute the decline to their advancing...


Editor's Note, DCMS #225

According to researchers from the CDC in Atlanta, medical spending attributable to diabetes per person doubled between 1987 and 2011. "The economic burden of the disease...


Letter from the Editor, #765

There are finally some guidelines coming from the Endocrine Society on treating obesity. This is significant because the guidelines signify the recognition...


Editor's Note, DCMS #224

Sometimes thinking out of the box really is necessary to find ways to help our patients. Rosalyn Sussman Yalow won a Nobel Prize for developing the radioimmunoassay technique that revolutionized drug molecule discovery. Her interest in unique...


Letter from the Editor, #764

This was a particularly aggravating week for both my patients and insurance companies. The new year has brought copays and deductibles to many of my Part D patients. Most of them had no idea that they now had a $200 deductible and swore that their...


Editor's Note, DCMS #223

I was at a recent CE program about healthcare costs and when it came to diabetes the speaker stated that it cost U.S. employers over 100 billion dollars a year and at least 20% of that amount was spent on non-medical costs with a lot going to lost...


Letter from the Editor, #763

This past week I have been at CES in Las Vegas. During the four days I was there, I spent three of them in the fitness, digital health, and wellness areas. There were over 350 exhibitors with products that they promise will revolutionize health and...


Editor's Note, DCMS #222

There is one conflict that consistently recurs in healthcare. This conflict is between the use of newer, more expensive medications and older cheaper ones. As we have...


Letter from the Editor, #762

Now that we have jumped into 2015 many of our patients will be trying to live up to their yearly repeated resolution to lose weight. They will look for every shortcut and newfangled device or product that will "guarantee" that this will...


Editor's Note, DCMS #221

We sometimes think that if our patients are told what to do they will do it. We tend to forget that there is much more to managing diabetes with insulin than with pills. Patients who are very persistent in taking their oral meds can be completely...


Letter from the Editor, #761

This is the time of year when our patients start to think about their New Year's resolutions and taking care of their diabetes is one of the things they often decide on. Unfortunately, this is usually used as an excuse to...


Editor's Note, DCMS #220

Here is a word that's associated with diabetes that you might not know -- micro­angiopathy. This problem affects between 10-15% of all diabetes patients and is often overlooked, even though it is very simple to diagnose. If you want...


Editor's Note, The Best of 2014

We all know that when it comes to healthcare, "analytics" is a word that has jumped to the forefront. Hospitals, prescribers, and insurance companies all can earn more money if their analytics are good, and can be penalized if the results...



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