November 1, 2016 : DCMS #317

DISASTERS AVERTED — Near Miss Case Studies

Sometimes You Gotta Use the Brand Name

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dr. Jeffrey Mechanick Part 1, Nutrition and Lifestyle

HOMERUN SLIDES — Great Clinical Presentation Highlights

Strategies for the Practical Management of Type 2 Diabetes Part 4

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #48: Biosynthesis, secretion, and action of glucagon Part 2 of 4

MOST POPULAR ARTICLES OF THE MONTH

#1 Towards a Game-Changing Type 1 Diabetes Vaccine
#2 Pioglitazone First Medication to Prevent Diabetes Progression Including Cardiovascular Events
#3 Making the HbA1c Value More Accurate

There have been three new classes of diabetes drugs that have changed the face of diabetes care over the past 7 years. Two of those are oral and one is an injectable, and they have been going head to head all that time. Now, rather than comparing them, clinicians are using them together. This week in our Homerun Slides we look at case histories on the use of two of these classes together and how patients can benefit.

Dave Joffe

Editor-in-chief

Many of our patients have intolerable GI side effects from metformin. We use ER to try to decrease these, but that doesn’t always work. If they have these symptoms, I recommend they take it slow and take it after they eat. If they still have problems, I recommend they break the tablet to 250mg, even though the label may say one shouldn’t break the tablet.

In part 1 of this Exclusive Interview meet Dr. Mechanick, current president of American College of Endocrinology, who has a focus on nutrition and lifestyle.

In this week’s Homerun Slides, the conclusion of type 2 diabetes management strategies. Two case studies show the role of DPP-4 and SGLT-2/DPP-4 combo treatments.

Physiologic effects of glucagon: Glucagon acts through binding to specific receptors located at the target cell plasma membrane. The major common effect of glucagon is to activate adenylate cyclase and to increase the intracellular production of cAMP. There is considerable evidence that binding of glucagon to its receptor activates an intermediate transduction process that involves the participation of guanosine triphosphate (GTP), divalent cations, and adenosine (or other similar natural substances).

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.

Study could not evaluate drug’s long-term effects on diabetes prevention, length of effects

New approach reduces significant errors from about one in three to about one in 10.