July 4, 2020 : Issue #1049

TOP STORIES — Diabetes News and Research

Exercising with Type 1 Diabetes: The Insulin-Food Balance Challenge 
by Sheri Colberg, Ph.D., FACSM

Could Carb Restriction Lead to Diabetes Remission?

Following the Effects of COVID-19 Quarantine on Glucose Management

Do you have a lot of your patients telling you about their success with Keto diets? It seems that for years we were concerned about these diabetes patients going into ketoacidosis if they tried a low carb, higher fat diet. Professionally we know there is a difference between ketosis and ketoacidosis and now it is important to make that distinction for our patients.

In the past weight loss and lower A1c values were thought to be the only benefits of a low carb, ketosis diet. However, this week our intern Maya Palmer, PharmD candidate from FAMU College of Pharmacy, has found excellent evidence that these types of diets can actually cause long term remission in type 2 diabetes. Check out her article to learn how often these patients become medication free.

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We can make a difference!

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Dave Joffe

Editor-in-chief

Gvoke HypoPen is the first FDA approved glucogon autoinjector for very low blood sugar. It is premixed and ready-to-go, with no visible needle.

by Sheri Colberg, Ph.D., FACSM

Addressing how to balance blood glucose levels during (and after) exercise with type 1 diabetes is not new. In fact, it is likely the KEY topic to address to be successful at being physically active if you take exogenous insulin and want to prevent hypoglycemia or hyperglycemia during exercise. Strategies include changing in insulin doses and/or supplementing with food, either of which can be done in myriad ways depending on the activity, timing and more.

Study examines the effectiveness of nutritional ketosis in reducing medication usage and increasing the chances of diabetes remission. 

With stay-at-home orders, daily routines for many diabetes patients have been disrupted, creating concerns over the possible consequences of added stress, isolation, and elevated blood sugars.

Once again, metformin has shown the ability to be a wonder drug.  Studies have shown that type 2 diabetes (T2DM) and obesity are significant risks for mortality in COVID-19. Now, according to a new study published by MedRxiv, women who were taking metformin had a 21% to 24% lower risk of dying from COVID-19, compared to men and those who didn’t take the drug, based on data from 6,200 hospitalized COVID-19 patients. The study also found that metformin lowered C-reactive protein levels twice as much in women as in men. Metformin has sex specific immunomodulatory effects which may elucidate treatment mechanisms in COVID-19.

“We know that metformin has different effects on men and women,” study coauthor Carolyn Bramante of the University of Minnesota said, adding that “In the diabetes prevention trial, metformin reduced CRP (the inflammation marker C-reactive protein) twice as much in women as men.”  Metformin also decreases levels of TNF-alpha, an inflammation protein that appears to make COVID-19 worse, she said. “The fact that we saw the benefit in women only, and the fact that metformin lowers TNF-alpha in female mice, might suggest that the TNF-alpha effects of metformin are why it helps in COVID-19.”

This small study has not yet been peer-reviewed. MedRxiv

See more of our coverage of metformin & COVID-19.

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

Stephanie Anderson, PharmD Candidate 2021, Skaggs School of Pharmacy and Pharmaceutical Sciences 

Sameen Khan, Pharm.D. Candidate, USF College of Pharmacy  

Maya Palmer, PharmD. Candidate, Florida A&M University College of Pharmacy

Stephen Rubano, PharmD. Candidate, USF Taneja College of Pharmacy 

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Steve and Dave
Diabetes In Control
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