October 2, 2018 : DCMS #417

DISASTERS AVERTED — Near Miss Case Studies

What Your Patients Don’t Want to Hear

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Richard Bergenstal on Automated Insulin Delivery

HOMERUN SLIDES — Great Clinical Presentation Highlights

Practical Use of CGM To Improve Clinical Outcomes Part 3

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #145: Glucose Toxicity Part 1

MOST POPULAR ARTICLES OF THE MONTH

#1 When and When Not to Use An SGLT-2
#2 A Major Diabetes Complication That We Fail to Address
#3 Nuts, Nuts, and More Nuts Lower A1c and Cardiovascular Disease

Sometimes we don’t share everything we know about a patient with them. We make that decision based on experience and how much data we think a particular patient can understand or use.

This is definitely true when we consider using monitoring technology with patients. The use of CGM has definitely raised questions as to how patients could use the data. Over the past couple of weeks, we have explored the use of CGM.

This week we looked at the benefits of giving the patients full real-time information and letting them use it to manage their own care.

Dave Joffe

Editor-in-chief

We recently had a new patient, 75 years of age, who has class I obesity and prediabetes, and has had hypothyroidism for over 25 years. She is very active and has purposely lost weight, about 6 pounds. She told me she has had hair loss over the years and has seen a specialist for this, but lately it’s been worse. She takes spironolactone, biotin, and zinc for her hair loss. She wanted to know what she could do about her hair. She is taking 150 mcg levothyroxine and 5 mcg liothyronine.

Richard Bergenstal, MD is an endocrinologist in Minneapolis, Minnesota and is affiliated with Park Nicollet Methodist Hospital. He received his medical degree from University of Chicago Pritzker School of Medicine and has been in practice for more than 20 years. Dr. Bergenstal accepts several types of health insurance, listed below. He is one of 5 doctors at Park Nicollet Methodist Hospital who specialize in Endocrinology, Diabetes & Metabolism.

In this week’s Homerun Slides,  we conclude this series with blinded versus unblinded CGM and CGM utilization.

Several studies, culminating in the large and definitive Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study have established that hyperglycemia is the major risk factor for microvascular diabetic complications. Chronic hyperglycemia also seems to be a significant and independent, albeit weaker risk factor for macrovascular disease. Other adverse consequences of hyperglycemia include an increased susceptibility to infections.

After reviewing evidence, a tool to evaluate benefit and risk has been developed for the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors.

Nonadherence to diabetes medications 2nd leading cause of hospitalizations

New study shows that nut intake may improve glycemic control and reduce risk of cardiovascular disease in people who have type 2 diabetes.