October 18, 2016 : DCMS #315

DISASTERS AVERTED — Near Miss Case Studies

Reteach to Dispel Fear and Misunderstandings

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dr. Yehuda Handelsman, Part 4 – Low Carb or Low Calorie?

HOMERUN SLIDES — Great Clinical Presentation Highlights

Strategies for the Practical Management of Type 2 Diabetes Part 2

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #46: Neuropeptides and Islet Hormone Secretion Part 5 of 5

MOST POPULAR ARTICLES OF THE MONTH

#1 Towards a Game-Changing Type 1 Diabetes Vaccine
#2 Can a 100-Year-Old Vaccine Bring Us a Cure for Type 1?
#3 Denial: Numbers Don’t Lie

Letter from the Editor
Oct. 18, 2016

After years of trying to figure out why the most tightly managed patient will just all of a sudden lose control, we have discovered that it is due to the parasympathetic, sympathetic, and sensory nerves that innervate the pancreatic islets. This knowledge is already being used to develop new drugs for glucose control. If you want to understand what effect these nerves have on glucose control and how important drugs can be to treat these nerve actions, check out our Clinical Text.

Dave Joffe

Editor-in-chief

Female, 76 years of age, type 2 diabetes, well managed, A1C 6%, on metformin 500mg daily. Patient also has well-managed hypertension, hyperlipidemia, and osteoporosis. She lives alone. Wants tighter diabetes control. Was having hypoglycemia when on 500mg twice daily. Requests, almost begs me, to increase her medication. States she’s afraid she’s going to have kidney problems.

Dr. Yehuda Handelsman talks with Diabetes in Control Publisher Steve Freed at the 2016 AACE Meeting. In part 4 of this Exclusive Interview, is it low carb or is it reduced calories? Dr. Handelsman explains when he recommends one over the other.

In this week’s Homerun Slides, the effect of GLP-1 within the human system.

Summary of present-day knowledge: We know today that the pancreatic islets are innervated by parasympathetic, sympathetic, and sensory nerves. The parasympathetic nerves stimulate insulin and glucagon secretion whereas sympathetic nerves inhibit insulin secretion and stimulate glucagon secretion; the net influence of the sensory nerves is not yet clearly established.

In part 3 of this exclusive interview, Dr. Faustman discusses how a cure based on the inexpensive BCG vaccine could permanently change type 1 treatment, and whether results could also apply to type 2.

In part 1 of this exclusive interview, Dr. Faustman discusses her research and why an old tuberculosis vaccine may lead us to a cure for type 1.

Woman, 64 years of age. History of Class II Obesity and hyperlipidemia. While she had obesity, her glucose levels were elevated. A1C 8.2%. She followed a lower carb meal plan, was active, took metformin and a GLP-1, a statin and an ACE-I. She lost 22% total body weight. A1C then remained in the 6-6.5% range for 3 years on this treatment plan. Over the past 8 months, due to insurance and her statement of denial that she ever really had diabetes, she stopped taking her glucose-lowering medication, statin, and ACE-I, wasn’t as strict with meal plan or activity, and stopped checking her glucose, but did not gain back her weight.