Wednesday , December 13 2017
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Letter from the Editor, #689

Over the past months there have been a lot of articles about the idea that Alzheimer’s disease may be another form of diabetes. In fact we have covered this information in previous issues of Diabetes In Control.

While looking through some recent studies I found one from the Annals of Neurology (Jun 2013) by Jackson K, Barisone G et.al. that could explain this connection. They explain that oligmerized amylin might accumulate in the cerebrovascular system and brain parenchyma of diabetic patients and could also occur in non-diabetic patients causing another kind of amyloid plaque leading to Alzheimer’s.

I had my PharmD Candidates review this study and examine the idea of using synthetic amylin and they found some interesting things you will want to check out.

Last week the assignment for my new interns was to calculate the ratios needed for conversion of a patient on Lantus and Humalog from a fixed dose with sliding scale to a basal bolus regimen based on carb ratio, correction factors and total daily dose of insulin. After some research they were all able to figure out these numbers. However, when I asked them to calculate the dose for a particular meal and glucose they had to get out the calculator and do math to make this work. Since they are all in their last year of professional school I figured these calculations would be easy to do on the fly whether at a restaurant or at home or on a camping trip. The difficulty they had demonstrates that using an automated calculator built into a blood glucose meter might improve A1c’s and convince more patients to switch to this method of glucose management. Now we have a study that shows this is true.

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Announcements:
 
From dLife.com: "dLife chef Michel Nischan prepares a nutty, chocolaty treat; Find the best produce for your diabetes when shopping the produce aisle; Jim Turner talks to your significant other about your diabetes; Dr. Jen Nash shares her insight on obesity on another dLifeTV viewer submission." Sundays live online at dLifeTV.com at 7 PM ET, 6 PM CT, and 4 PM PT. Keep up on the latest dLife news at dLifeTV.com.
 
With a day packed full of education, motivational tools, one-on-one sessions, and workshops, the TCOYD health fair is a great way to get your patients to take better care of their health and themselves. TCOYD.com

 
Please answer this week’s poll: Do you recommend metformin for prediabetic patients (FBG 102-125mg/dL or A1c 5.7-6.4%)?
 
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We can make a difference!
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Dave Joffe, Editor-in-chief