March 21, 2020 : Issue #1034

TOP STORIES — Diabetes News and Research

Redesigning Primary Care to Improve Diabetes Outcomes (The UNITED Study)

Empagliflozin Produces Liver Fat Reduction in Randomized Control Trial

SPECIAL FEATURE

Managing Your Exercise in a Pandemic:
10 Easy Exercises to Build a Strong Core Without Leaving the House

by Sheri Colberg, PhD

Being a member of the Medicare community, I get daily emails about my health from my advantage plan company and Silver Sneakers. Silver Sneakers is a benefit that allows you to belong to almost any gym you want for no charge. The emails encourage you to take advantage of these gyms for things like yoga and weight training, HITT classes, and more. The problem for a lot of us is, the social isolation that we need to slow the Corona virus means that these gyms and Y’s are closed, so WHAT are we to do?

Our exercise expert, Dr. Sheri Colberg, comes to the rescue with a full feature on how to Build and Maintain a Strong Core without ever leaving the house. If you do the first exercise 100 times, send me an email.

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We can make a difference!

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Dave Joffe

Editor-in-chief

The FDA on Tuesday approved safety labeling changes for all SGLT2 inhibitors, recommending temporary discontinuation of the medications before any scheduled surgery to avoid potential risk for diabetic ketoacidosis. 

What if improving diabetes care was as easy as changing the way we interact with patients? 

Could empagliflozin contribute to the early treatment of NAFLD in patients with T2DM? 

By Sheri Colberg, PhD

Just in time for the novel coronavirus (COVID-19) social distancing and closures of gyms and fitness centers in many areas, here’s a revisit of many important core exercises you can do at home to keep yourself strong and healthy, with an illustrated PDF you can print out.

Diabetes is a leading cause of stroke, especially ischemic stroke. Patients with type 2 diabetes have an increased risk of stroke estimated to range from 150% to 400% compared with those without diabetes. The association between hemoglobin A1c (HbA1c) and stroke risk, along with its subtypes, is rarely reported. A recent study investigated the association between HbA1c and the risk of incident stroke in patients with type 2 diabetes based on real-world data from three healthcare systems.  This large health system-based cohort of 27,113 African Americans and 40,431 whites with T2D was completed over four years.  It was found that 7,735 patients developed stroke (6,862 ischemic and 873 hemorrhagic).  The results showed a U-shaped association, which showed that both lower HbA1c and higher HbA1c levels were associated with higher risks of incident stroke. The U-shaped curve was more pronounced among patients taking antidiabetic, lipid-lowering, and antihypertensive medications compared with those without these medications. In the analysis restricted to stroke cases only diagnosed by inpatient or emergency, the U-shape association appears more pronounced. These results indicate that both intensive and poor glycemic control might be associated with an increased risk of stroke in patients with type 2 diabetes. These data suggest that diabetes management may have to be individualized according to the guideline recommendations rather than intensively attempting to lower HbA1c. 

Comment from Dr. Richard K. Bernstein, publisher of “Diabetes Solution”:  

The possible reasons for the study showing a U-shaped curve are the fact they show that those in the lowest A1c group got the most medications, including antidiabetic, lipid-lowering, and antihypertensive medicines compared with those without these medications.  Also, the time frame was only 3yrs, not enough time to destine a person for stroke unless on an anticoagulant. It is often the case that type 2s with the lowest A1c get the most meds.  And there are several commonly used meds for diabetics that can cause strokes. 

Journal of Stroke 2020;22(1):87-98. Published online: January 31, 2020 

DOI: https://doi.org/10.5853/jos.2019.01704 

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletters:

Mia Flowers, PharmD. Candidate of Florida Agricultural & Mechanical University  School of Pharmacy 

George McConnell, PharmD. Candidate, LECOM School of Pharmacy

Mit Suthar, PharmD. Candidate, LECOM School of Pharmacy 

Chardae Whitner PharmD Candidate L|E|C|O|M Bradenton School of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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