January 16, 2016 : Issue #816

• Influence of Dietary Protein on Postprandial Glycemic Control 
• Basal Insulin Peglispro vs. Insulin Glargine
• Association Between Pulmonary Function and Development of Type 2 Diabetes or Metabolic Syndrome
• Patients with Prediabetes at Risk for Early Kidney Damage
• Intranasal Glucagon on the Horizon for Diabetics
• Early Onset of Diabetes Poses Greater CVD Risk

I was traveling this past week and it seemed that almost every person was wearing some kind of fitness tracking device. As I was going through the Atlanta airport, I watched people checking their devices and commenting on their steps while they were walking underground between terminals. When I sat on the plane, the couple on the right of me had two different devices. They were comparing the results of walking between flights and trying to find out why there was a 60 step difference. When I asked them about their activity, they were quick to tell me that they really never did any exercise, but when their kids gave them these devices they decided to try to get more steps every day and see who had the most. They were even using a phone app to compare their results.

We are currently trying out some of these devices and will be sharing our impressions with you in the future.

Sleep apnea is a condition that occurs in many of our patients with diabetes and is also linked with hypertension. This can be seen by visiting http://www.diabetesincontrol.com/sleep-apnea/

This week our intern Jennifer Zahn found an article on how pulmonary function affects diabetes, and then did an in-depth analysis to give you a total presentation on how to best use pulmonary function to evaluate the risk of diabetes.

Announcements:

Free CME Courses
Our web site CME resource is back online! Be sure to check out the new CME courses posted there. Courses are currently available on topics including: Advances in the Medical & Surgical Management of Obesity; Diabetic Retinopathy; Strategies to Improve Prevention and Treatment of Diabetes; and more!

dLifeTV.com: Sunday, January 17, 7PM ET

From dLife.com: “The life and legacy of the man who shattered baseball records and racial barriers, but struggled against diabetes – Jackie Robinson. Also, a look at the language of diabetes; and the facts on an important women’s health issue that could be affecting you.” 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.

*****************************

We can make a difference!

*****************************

Dave Joffe, Editor-in-chief

Since recent developments in the use of SGLT-2 inhibitors, are you positive or negative in recommending to your patients? Follow the link to respond.

The new inhaled insulin could be available this year possibly.  Eli Lilly purchased  the product from Locemia Solutions.  The glucagon inhaled nebulizer can now be used by the patient and not a caregiver.  There is no mixing so it can be administered more rapidly.  It is now in a phase 3 study. Check it out in item #5.

Mrs. O’Doole is a 34-year-old of Irish descent. She works as florist and is married with three children. She arrives at your clinic for her annual wellness exam. Her blood pressure is 130/84 mmHg, pulse 65, BMI 24 kg/m2 and her physical exam is notable for acne and mild hirsutism. Her only current medication is oral birth control pills. She recalls starting OCP, 15 years prior, due to irregular menses. What clinical diagnosis would suggest screening Mrs. O’Doole for type 2 diabetes? Follow the link to answer.

‘The freeze-dried poop method’ might not sound like a weight-loss strategy that would catch on, but, as some researchers are now testing, it may be an effective way to slim down. A trial will offer some of the first human data on microbe transplants and weight.  In a randomized, controlled clinical trial starting this year, researchers will test out such a fecal formula for the treatment of obesity. They’ll also try to glean critical details about the human microbiome and its role in our health and metabolism. The trial will involve taking fecal samples from lean, healthy donors then freeze-drying the stool, putting a gram or two into capsules, and giving them to 20 obese patients. Such poop-packed pills, which are designed to replace a person’s intestinal microbes with those from a donor via their feces, have proven effective at treating tenacious gut infections. This has led researchers to ponder whether the transplants could remedy other health problems, including obesity and metabolic disorders. A few animal studies and some anecdotal data in humans suggests the answer is yes.  Patients will receive weekly poop doses for six weeks, then researchers will track their weight and health at three, six, 12 months, and possibly beyond depending on how the trial goes. If it works, we can do all of the detail-oriented work to try to figure out which microbial communities are being affected to give more information for targeted treatments in the future.

Consider protein intake in addition to counting carbohydrates when calculating insulin doses.

Basal insulin peglispro, lacking peripheral action, was compared to insulin glargine in a 52-week trial in type 2 diabetic patients previously treated with basal insulin.

Can decreased lung function be used as a diabetes predictor?

Research study finds high levels of glucose could be affecting kidneys even prior to diabetes diagnosis.

Product may offer simpler solution to hypoglycemia over intramuscular injections.

Patients with diabetes two to four times more likely to have heart complications than those without.

Quote of the Week!

“Out of difficulties grow miracles.”

…Jean de la Bruyere

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

Jimmy Tran, LECOM College of Pharmacy

Javeria Fayyaz,  LECOM College of Pharmacy

Sabair Pradhan,  University Of South Florida College of Pharmacy

Jennifer Zahn,  University Of South Florida College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
810 Bear Tavern Road Suite 102
Ewing, NJ, 08628
USA
www.diabetesincontrol.com