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 responsibilities they would have, we got stuck at glucose monitoring. I finally got their attention when I told them that anytime their glucose goes over 180 mg/dl that they were going blind, losing their feet and ruining their kidneys. The patient with the 13 A1c or 380 average BG told me her vision was much worse and wanted to know why. I went over retinopathy with her and then let her know that Diabetic Macular Edema (DME) was causing most of her problems. This week, we are starting a new Homerun Slides series from Dr. Paul Chous, MA, OD, FAAO, focused on DME.
Our Diabetes Disaster Averted looks at how often patients get in trouble when they think that exercise only causes low glucose levels, and our Clinical Text continues that trend by looking at all the reasons a diabetes patient might end up in the Emergency Department.
We also have an excellent interview with Dr. Barbara E. Corkey, who brings us real science on how new plastics, fire retardants and pesticides could be causing obesity and diabetes.