Tethys Bioscience's PreDx™ Diabetes Risk Score(DRS)

Sharon Vacha, Dr of Pharmacy Candidate, 2010 Dave Joffe, Editor Tethys Bioscience has developed a predictive blood test to evaluate a patient's 5 year risk of developing Type 2 diabetes. This company has articles in two publications, Diabetes Care and The Journal of Diabetes Science and Technology, outlining how they came to the final product and results of a study they conducted using this new test. According to Tethys this will enable medical professionals to focus their efforts on reducing the risk of patients most likely to develop the disease and possibly reduce the consequences of having it. The articles published indicate that Tethys PreDx Diabetes Risk Score (DRS) is a better predictor of risk than the tools currently used.   The traditional methods for evaluating a patient with potential for T2DM include impaired fasting glucose test and oral glucose tolerance test and also non-invasive anthropometric indices. The non-invasive anthropometric indicators like BMI, age, family history, gender and waist circumference have less specificity than invasive measures. The IFG test and the OGTT have several problems but the most problematic is that by the time a problem is discovered damage may already exist.   The DRS tests fasting serum using biomarkers found by Tethys to be the most valuable when trying to determine an individual's risk for developing Type 2 diabetes. These are adiponectin, C-reactive protein, ferritin, glucose, hemoglobin A1c, interleukin-2 receptor alpha and insulin. These biomarkers show different paths of diabetes development like inflammatory response, metabolic disorders, fat and carbohydrate metabolism, coagulation and cell death. The results assign a patient a lowered risk, a moderate risk or high risk.   The study used patients from the Inter99 Cohort, a Danish study that followed 61,301 subjects between 30 and 60 years old to examine effects of lifestyle changes on cardio vascular disease. Of these 61,301 patients 6,784 were followed for their rate of progression to Type 2 diabetes.  The subset included people who had no diabetes at baseline, age ≥39, BMI≥25 kg/m², impaired fasting glucose (100-125mg/dl) and metabolic syndrome. The results showed that the PreDx DRS model was statistically significantly better at predicting five year risk of T2DM than fasting plasma glucose, fasting insulin, HbA1c and non-invasive values.   The PreDx Diabetes Risk score blood test can be useful in predicting a person's risk for developing Type 2 diabetes in the next five years. It will give you a quantitative measure of an individual's risk by simple blood test. What remains to be seen is what potential diabetic patients do with this information. It is, after all, up to the patient whether or not to implement the lifestyle interventions recommended by their medical professional.      J Diabetes Sci Technol Vol 3, Issue 4, July 2009 DIABETES CARE, VOLUME 32, NUMBER 7, JULY 2009

Blood Sugar 101: What They Don’t Tell You About Diabetes

Every few weeks there seems to be a new book for diabetes. Often these books are a compilation of studies, reports and data. This week we have a review of a new book that really explains how our bodies work when it comes to blood sugar control: Blood Sugar 101: What They Don’t Tell You About Diabetes written by Janet Ruhl. The review was prepared by Karen Linz, JD, MBA, PharmD Candidate, University of Florida College of Pharmacy.

What Is In It For Me?

M. Teresa Volpone, PharmD, CDE, BC-ADM is back with a new article “What Is In It For Me?”. This year’s AADE educator of the year focuses on how we can get our patients to actually change behavior.

A New Class of Drugs for Improving Blood Sugars – Bile Acid Resins

When our publisher, Steve Freed, BSPharm, and I first got together it was because I had found a soluble fiber product that lowered cholesterol levels and seemed to help control glucose levels. Steve explained that this fiber worked as a “bile acid sequestrant. Now he has found a whole class of drugs that work the same way, without the muss and fuss of mixing powder.

A1C Levels may one day be used for diagnosis

Fasting Glucose over 126mg/dl or 2 random glucose readings over 200mg/dl mean your patient has diabetes. But what about their A1c? We use to measure therapy success, but what about using A1c to diagnose diabetes? According to David Sacks, MD, Assistant Professor of Pathology Harvard Medical School we should be officially doing that now. Click here to learn how that might change

Byetta And Pancreatitis- What The Headlines Don’t Say

In case you’ve escaped the sensationalist media reports about the Byetta-pancreatitis issue, this week the FDA issued a new warning after six cases of necrotizing pancreatitis in Byetta users came to light. Overall, the numbers are small. The annual rate of pancreatitis among people not on Byetta is about 17 per 100,000 people, which is actually above the rate seen in people on Byetta. Furthermore, this baseline number ignores known associations of diabetes, obesity, and dyslipidemia with pancreatitis. In addition, other drugs often taken with Byetta including sulfonylureas, ACEI/ARB, diuretics, and fibrates increase risk of pancreatitis. Learn more by reading Byetta And Pancreatitis- What The Headlines Don’t Say by Ruben Salazar, Doctor of Pharmacy Candidate, UF College of Pharmacy

H.R. 4218:

This week we want to know if you think this will make it easier for patients to get care?

Too Fat? Common Virus May Be To Blame: Update

Have you tried to refer a child to a pediatric endocrinologist lately? According to the Journal of Pediatrics it may be harder than you think. For every 290 children with diabetes in the United States, there is only one board-certified pediatric endocrinologist, and 2 states, Montana and Wyoming reported no board-certified pediatric endocrinologists. A few months ago we reported that a common virus caused human adult stem cells to turn into fat cells and could explain why some people become obese. Now there a diagnostic test to see if you have that virus. Check out what Obetech has for you to use.

Cheating Destiny: Living with Diabetes

A few weeks ago we had an article by the endocrinologist Irl Hirsch. What many of you may not know is that his brother James, also has diabetes and has written a book about his and other folks experiences with the disease. Leigh Anne Bowen, University of Florida Doctor of Pharmacy Candidate, has reviewed his book Cheating Destiny: Living with Diabetes.

EXENATIDE LEADS TO REDUCTION IN LIVER ENZYMES IN DIABETICS INDEPENDENT OF WEIGHT LOSS

I just got back from the AACE Annual sessions in Orlando. It was great to see a lot of you and appreciated the nice comments you had about our newsletter. I did not have a lot of time to put together an overview for out deadline but did want to share an abstract of interest. Deepti Bulchandani, MD and his colleagues have looked at Exenatide for the treatment of elevated enzymes in Non alcoholic fatty liver disease. This is another possible reason to start your patients on Exenatide. Click here to learn more.