September 26, 2015 : Issue #800

• Anti-Diabetic Drug and Superior Reduction of Cardiovascular Death in T2DM Patients
• Bacterial Link Between Heart Disease and Gum Disease Clarified
• Glucose Levels in Pregnant Women Affect Fetal Heart Rate
• Another Balloon Device “Orbera” Approved for Weight Loss
• Correlation Found Between Loss of Blood Flow, Retinal Damage in Diabetes
• Middle-Aged Marijuana Users May Have Poor Blood Glucose Control
• Is There an Increased Risk of Cancer Associated with Glyburide Treatment?
• The Relationship of Onglyza (Saxagliptin) and Fracture Risk in Type 2 Diabetes
• Bone Fracture Risk with Rosiglitazone Can Be Lowered with Exercise
• High-Calorie Diet Causes Insulin Resistance Within Days

We’re excited to let you know that on October 1st, 2015, we will be relaunching DiabetesInControl.com. The refreshed site will feature a clean, new look and feel, with enhanced navigation to make it even easier to find all our great content. We’ve also decided to make some of our most popular content, including our “Tools for Your Practice,” subscriber-exclusive to reward our loyal readers. In order to access this content, you will need to register your subscription email address on the new website. Please look for the link to register in the October 3rd e-newsletter.

There is more information on the positive effects of Jardiance (empagliflozin) on CV health and why this might not be a classwide effect, but specific to empagliflozin. See full article.

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Announcements:

dLifeTV.com: Sunday, September 27, 7PM ET

From dLife.com: “Experts explain how to prevent and treat problems with your largest organ — your skin. Then, satisfy your sweet tooth with sugar-free cheesecake in the dLife kitchen. Also, Jim Turner follows up on the diabetes life of Major League Baseball’s Dmitri Young.” Sundays live online at dLifeTV.com at 7 PM ET, 6 PM CT, and 4 PM PT. Keep up on the latest dLife news at dLifeTV.com.

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We can make a difference!

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Dave Joffe, Editor-in-chief

Studies have shown that 40-80 percent of the medical information patients receive is forgotten immediately and nearly half of the information retained is incorrect. One of the easiest ways to close the gap of communication between clinician and patient is to employ the “teach-back” method, also known as the “show-me” method or “closing the loop.” …

Under normal circumstances, blood glucose levels vary throughout the day. While it may not be of much significance to a healthy subject, the degree of these changes is of great importance to individuals with diabetes.

Orbera is a non-surgical intragastric balloon device that has been used for weight loss outside of the United States for over 20 years. It is now FDA approved to be used in the United States. The device is indicated for weight reduction in obese patients with a BMI of 30 to 40 kg/m2 who have been unable to lose weight with diet and exercise. The non-surgical procedure takes about 30 minutes. See full article

Your patient has been taking metformin, glipizide and a daily basal insulin dose (.85 U/kg/day). While his fasting glucose levels are on target, he have not yet been able to reach his individualized glycemic target of A1C<7%. In your discussion with him about the addition of a prandial insulin dose to his regimen, you compare and contrast his options. Compared to basal insulin alone, premixed insulins: Follow link to give your answer!

A gap in scientific knowledge about a family of drugs that are used to treat type 2 diabetes has been highlighted in a new study. Researchers behind the study say that while their results are speculative at this stage, they point to a lack of complete information about the potential impact of a group of treatments known as GLP-1 agonists, or incretin mimetics. In particular, their survey found that one such treatment has the hitherto unrecognized potential to activate receptor sites for the hormone, glucagon. This can promote the release of glucose into the blood, which is a process that GLP-1 agonists are supposed to prevent. The paper stresses that these are only initial findings, and that more in-depth research will be needed before “definitive conclusions can be drawn” about the existing results. Journal Of Biological Chemistry Sept 20, 2015

Findings suggest significant reduction in the risk of CV death and all-cause mortality for T2DM patients with a history of CVD.

A bacterial species common to both diseases increases arterial inflammation by altering gene expression.

Future study to focus on effect of continuous glucose changes in both maternal and fetal health…

Orbera is a non-surgical intragastric balloon device that has been used for weight loss outside of the United States for over 20 years. It is now FDA approved to be used in the United States. The device is indicated for weight reduction in obese patients with a BMI of 30 to 40 kg/m2 who have been unable to lose weight with diet and exercise. The non-surgical procedure takes about 30 minutes. See Item #4

New ultra-wide-field technology gives ophthalmologists opportunity to view 80% of retina…

There was as much as a 23% difference in insulin levels and as much as a 62% variation in blood glucose control among diabetes patients who shook and didn’t shake their NPH insulin pens before injecting, according to a study. Researchers found patients who didn’t shake the pens before injecting had lower insulin levels if they injected the needle flat or pointing up, and higher insulin levels if the needle was facing down. Compared with resuspended NPH insulin, lack of resuspension profoundly alters PK/PD and may contribute to day-to-day glycemic variability of type 1 diabetes. — Published online before print September 10, 2015, doi: 10.2337/dc15-0801 Diabetes Care September 10, 2015

Prediabetes risk significantly increased, but diabetes risk yet to be determined…

Higher cumulative doses and duration of glyburide may be associated with increased risk…

Risk found to be neutral, but duration of diabetes and increased risk of bone fracture need further study…

Patients on PPAR-gamma agonists advised to find suitable physical activity…

The link between obesity and diabetes possibly uncovered…

There was as much as a 23% difference in insulin levels and as much as a 62% variation in blood glucose control among diabetes patients who shook and didn’t shake their NPH insulin pens before injecting, according to a study. Researchers found patients who didn’t shake the pens before injecting had lower insulin levels if they injected the needle flat or pointing up, and higher insulin levels if the needle was facing down. Compared with resuspended NPH insulin, lack of resuspension profoundly alters PK/PD and may contribute to day-to-day glycemic variability of type 1 diabetes. — Published online before print September 10, 2015, doi: 10.2337/dc15-0801 Diabetes Care September 10, 2015

Asian-Americans develop type 2 diabetes at lower BMI than the general population…

Fiber found to reduce absorption rate of glucose in rats…

Quote of the Week!

“If you rest, you rust.”
…Helen Hayes

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

Ashley Garringer, USF College of Pharmacy
Bic Huynh, LECOM College of Pharmacy
Shawn Vahabzadeh, USF College of Pharmacy
Kristie Huynh, LECOM College of Pharmacy
Jaydeep Patel, USF College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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