November 15, 2016 : DCMS #319

DISASTERS AVERTED — Near Miss Case Studies

Time Will Tell What Patient Will Do

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dr. Jeffrey Mechanick Part 3, Simplifying Aspects of Diabetes Care

HOMERUN SLIDES — Great Clinical Presentation Highlights

Continuous Glucose Monitoring in the Hospital Part 2

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #50: Biosynthesis, secretion, and action of glucagon Part 4 of 4

MOST POPULAR ARTICLES OF THE MONTH

#1 ADA Issues New Recommendations on Physical Activity
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#3 When Losing Weight, Warn ’em!

Editor's Note
Nov. 15, 2016

This past week, I received a packet of new information on managing diabetes. It was provided by a pharma company and developed by one of the most prestigious diabetes education centers in the world. This was a packet that we could share with our diabetes patients, so they could manages their disease “easily.”

Male, 21 years of age has class III obesity, binge eating disorder, fatty liver, and asthma, and was recently diagnosed with type 2 diabetes. It is his freshman year at a college away from home. He eats in the cafeteria, and has no refrigerator or stove in his room. He visits today after not taking metformin or GLP-1 agonist since at starting school. He is under a lot of stress and states the food at school is terrible, unhealthy, and not diabetes-friendly at all. Note, he has been taught a lower carb meal plan. He says he is not taking Glucophage or Victoza; each of them at low doses gives him terrible diarrhea. He states he checks his glucose twice a week, with fastings in the 90-100 range. He is up 10 pounds since our last visit in September.

Dr. Jeffrey Mechanick talks with Diabetes in Control Publisher Steve Freed at the 2016 AACE Meeting. In part 3 of this Exclusive Interview, Dr. Mechanick explains how he disseminates diabetes care information to his patients in an easy-to-understand manner over time.

In this week’s Homerun Slides, the Biostator artificial pancreas, first introduced in 1979.

Glucagon and diabetes: Plasma levels of glucagon have been found to be increased in all experimental and clinical forms of diabetes mellitus. This disturbance undoubtedly contributes to the hyperglycemia of the disease and excessive ketogenesis of diabetic coma. Numerous studies have shown that failure of glucagon suppression contributes to postprandial hyperglycemia in type 1 and type 2 diabetes.

Updated guidelines suggest short periods of movement every 30 minutes.

There has been a controversy over the last 30 years as to which is the best diet to prevent diabetes.

I work in obesity medicine. As many of us know, losing weight isn’t the problem for most, but weight regain is.

As the saying goes for many, you can’t be rich enough or thin enough. Many of our patients come in with unrealistic goals regarding their weight loss, and don’t give themselves enough credit for the weight they have lost. Many, for many reasons, regain.