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Letter from the Editor, #766

Jan 29, 2015

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 age. But now a new study has found that a decrease in protein consumption may be causative. When researchers compared patients on 10% vs 17% protein diets, they found that the men on the lower protein diet had less muscle mass and more catabolism. In fact, although these patients could adapt to a lower protein diet they were not able to reach nitrogen equilibrium and so muscle was lost. This gives you an additional reason to encourage your patients to start their day out with 25-30 grams of protein.

Many of us remember a drug called Galvus that almost made it to the market in the U.S. This was Novartis’ brand name for their DPP-4 inhibitor which was at least a year ahead of the first approved drug in that class, Januvia. The FDA withheld approval, however, because of skin lesions in monkeys. There was a lot of talk in the medical community that it was because DPP-4 and other DPP inhibitors might have a negative effect on other organs in the body. A new study from the United Kingdom Clinical Practice Research Datalink has examined the potential negative effects that DPP-4 inhibitors might or might not have.


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Dave Joffe, Editor-in-chief