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Letter From The Editor

Letter from the Editor #656: Extending Patients’ Lives by Five Years

We are coming to the end of the holiday season and many of our patients are starting to think about what they will do for their health in the new year. Some of them have asked for exercise equipment or gadgets as a holiday gift, and others have...


Editor's Note DCMS #114

Adipocytes, hormones, pro-hormones, cytokines and enzymes are all found in adipose tissue but what does this have to do with the endocrine system? Can they affect total-body metabolism and cardiovascular health? This week our excerpt from the...


Letter from the Editor #655: How to Avoid Burnout

Many of us have been seeing patients for a long time and as we squeeze more patients into each hour to be profitable, there is an increasing risk of burnout. This burnout can lead to misdiagnoses according to Dr. Paul Griner, MD, and past...



Editor's Desk, DCMS #113: Upcoming Changes in the Healthcare System

This past weekend I delivered a talk on "Provider Evolution: Medical Homes and Accountable Care Organizations (ACOs)" to a large group of medical professionals. Two of the slides stood out like big red bullseyes. The first ranked the...


Letter from the Editor, #654

There are some looming issues in reimbursement for healthcare coming in the next year. If things don't change prescribers will be faced with a 27% decrease in reimbursement rates for Medicare and Medicaid...


Editor's Note DCMS #112

Each week we try to bring you useful information on how to improve your patients' care. Most of us have come to realize that no one method or idea works for every patient so when our staff selects information for you we try to bring you solutions...


Letter from the Editor #653

Hope everyone had a great Thanksgiving and that you found everything you wanted during your Black Friday shopping spree. During the recent Liver Meeting 2012 in Boston


Editor's Note DCMS #111

According to dictionary.com, "iatrogenic" is defined as an adverse effect induced in a patient as the result of a physician's words or actions, especially as a consequence of taking a drug prescribed by the physician. No other drug...


Letter from the Editor #652

As we try to address the burgeoning problem of diabetes worldwide, studies dealing with food choices or physical activity always catch our attention. We want to take advantage of the results and apply them to patients regardless of whether the...


Editor's Note, DCMS #110: Insulin Degludec Slides and More

Last week we reported that the FDA advisory board had given their blessing to the new long-acting insulin, degludec. However, trying to find good information about this product, how it works, and what makes it different from insulin glargine or...


Letter from the Editor #651

This week week the FDA's Endocrinologic and Metabolic Drugs Advisory Committee recommended that degludec, Novo's new long acting insulin, be approved for use in the United States. There was a lot of the usual fuss about CV studies that seems...


Editor's Note, DCMS #109: Hypoglycemia

Hypoglycemia is always on every medical professional's mind when they think about using insulin. It doesn't really matter if the patient has type 1 or type 2 diabetes, or is well-controlled or out of control. As long as they are on insulin there is...


Letter from the Editor #650

Last week CMS finally issued guidelines temporarily increasing primary-care physician payments from Medicaid. The new Medicaid Rule (click here for...


Editor's Note, DCMS #108: Some Like It Hot But....

Years ago, Tony Curtis, Jack Lemmon, and Marilyn Monroe starred in the movie, "Some Like It Hot," and it was an instant hit for the three of them. However, when it comes to insulin, hot is never a good thing and this week's Disaster...


Letter from the Editor, #649

As part of our education program for diabetes patients we encourage them to do multiple small things which can promote weight loss and healthier living. A couple of examples we've given here include adding protein to breakfast, and beans or lentils...


Editor's Note DCMS #107

Over the past few weeks we have been sharing excerpts from Diabetic Emergencies: Diagnosis and Clinical Management on how to manage diabetic ketoacidosis in adults, and you have made this series one of the most read ever.  This week we...


Letter from the Editor #648

I have spent the past 10 weeks criss-crossing the country talking to pharmacy groups about the value pharmacists add to the care of hypertension through MTM (medication therapy management). Many Part D providers have...


Editor's Note, DCMS #106: Timing Is Everything

Timing is everything and without a doubt this is true when it comes to eating, obesity and weight loss. This week's Clinical Text from JOSLIN’S DIABETES DESKBOOK – A Guide for Primary Care Providers gives us some


Letter from the Editor #647

Years ago, just out of pharmacy school, I worked in a nursing home pharmacy where we supplied the oral and IV medications for several facilities. When we could not get an IV started in a patient we used a drug called hyaluronidase to increase...


Editor's Note: Rhinocerebral Mucormycosis

The complication of the week seems to be rhinocerebral mucormycosis. If you are not familiar with this infection then check out this week's Homerun Slides, which include a section on


Letter from the Editor #646

The EASD meeting was chock full of news about the latest drugs and new classes of medications. In one important...


Editor's Note, DCMS #104:

We are all aware of the problems which can occur when our patients take too much insulin or sulfonylureas, potentially leading to dangerously low blood glucose levels. But can you imagine that a diabetes patient could end up beaten and in jail...


Letter from the Editor #645

This week we have an article in the European Heart Journal that points out having high levels of cardiorespiratory fitness can actually help an obese...


Editor's Note, DCMS #103

Each time we see our diabetes patients we stress lifestyle modifications. We know that our patients want to improve but we also know how hard it can be. This week, we feature Homerun Slides prepared by Margarita Stanosyan, Doctor of...


Letter from the Editor #644: The "Arnold Factor" and Waist-to-Hip Ratio

Years ago we made a determination that BMI was the most important indicator of a person's risk for diabetes, hypertension and heart disease. We even use a BMI value to determine if a person is either obese or just overweight. However there was...


Editor's Note, DCMS #102: All About Sugars

Did you know that fructose is the only sugar that does not need insulin to be absorbed into the muscles or fat cells? If you give a little thought to this, then you might think that fructose would be a good energy source for athletes. However for...


Letter from the Editor #643 My Well Planner

About two months ago I was asked to be on an advisory board with other medical professionals, including physicians, nurses and other CDE's. We were brought together to review a new web portal for diabetes patients. Like most of my colleagues in...


Editor's Note, DCMS #101: Medication Errors

I did a program in Nashville this past weekend for a group of pharmacists on medical errors. One of the slides shows that when it comes to medication-related errors,  the ISMP, IHI and Joint Commission all agree that insulin is the...


Letter from the Editor: Lifestyle Changes and GLP-1

Seven years ago the first line therapy for the onset of type 2 diabetes was lifestyle changes and often we would take up to a year of trying various exercise and diet methods before we started medication. Because diabetes has reached epidemic...


Letter from the Editor #642: Seinfeld, Shrinkage and Diabetes

Most of us have seen all of the episodes of Seinfeld enough times that a single word or phrase brings back memories. Just the mention of the name, "Newman," conjures up images of the overweight and probably pre-diabetic mailman who...


Editor's Note, DCMS #100:

Many of you sent some great feedback in on last week's Homerun Slides on Leveraging Weight...


Letter from the Editor #641: Starting ACE-Inhibitors at Diagnosis

This week we have an interesting item from a very large study on the benefit normotensive patients with diabetes can receive by lowering their blood pressure when it comes to the risk of heart attack, stroke, and renal failure (


Editor's Desk, DCMS #99

This week we are honored to present an excerpt from Diabetic Emergencies: Diagnosis and Clinical Management. This new text provides highly practical, clear-cut clinical guidance for serious diabetic emergencies like ketoacidosis,...


Letter from the Editor, #640: Is There a New Cure for Type 1 with an Old Vaccine?

This week, there's a lot in the press about the use of an old TB vaccine to "cure" type 1 diabetes. Our publisher, Steve Freed, has put together a fantastic synopsis that cuts through the hype and delivers the real story: check out Item...


Editor's Desk: The Glycemic Index and How to Use It

Each week patients come to our classes with a new way to control their glucose levels. One of the methods of choosing foods that we often discuss is the Glycemic Index. This rating of the glucose raising effects of different foods was first brought...


Letter from the Editor #639: Telephonic Management of Diabetes

I have been traveling for the past two weeks to talk to pharmacists about the "Impact of Medication Therapy Management (MTM) on Hypertension Control and Adherence," and will have the opportunity to share this information with over 25...


Editor's Desk: Physical Activity and Diabetes Prevention

We often discuss the value of physical activity with our diabetes patients, and focus on how this helps control glucose levels. When it comes to our insulin-using patients, we add information about exercise induced hypoglycemia as well. This week...


Letter from the Editor #638: Students with Diabetes

Most of the time we are treating patients with type 2 diabetes, and sometimes we lose sight of our type 1 patients. The majority of these patients develop type 1 at a young age and are referred to a pediatric endocrinologist for treatment. These...


Editor's Desk: Medical Nutrition Therapy and Diabetes

Did you know that medical nutrition therapy (MNT) has been around longer than insulin? In fact, MNT for diabetes care goes back over 200 years. Our Clinical Text from Joslin's Diabetes Deskbook,


Letter from the Editor, #637: Should we be more aggressive in treating our newly diagnosed type 2 patients?

Steve, Andrew and I would like to extend a warm thanks to all the educators who stopped by our booth at the AADE meeting in Indianapolis. We are especially thankful to those of you who took the time to be interviewed...



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