Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals… News and information for Medical Professionals.
Letter from the Editor
Are you ready for the opening of a large can of worms, when it comes to classifying diabetes? We have all heard type one, type one and one half, type two, type 3, adult onset, MODY, LADA and many other ways of naming diabetes, and now top researchers and endocrinologists have gotten together to set up a whole new criteria and classification system. The new system, based on β-cell centric classification schema, was just released in Diabetes Care. See Item #2.
One of the experts responsible for all this hubbub is one of our Advisory Board members, Dr. Stanley Schwartz. Because of our unique relationship with him he gave us a private set of video interviews with our Publisher, Steve Freed, to explain not only the classifications but also how to best treat the “Egregious Eleven.” You can view the videos here – and if you wish, submit a question for Dr. Schwartz.
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: “A dLife special presentation of the award-winning “Story of Insulin” The amazing saga of the discovery of this life-saving drug and how it has made a difference in the lives of millions.” 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
This Week's Poll
Would you like to see a different classification for diabetes instead of type 1, type 2, type 1½, LADA, etc.? Follow the link to respond.
New Product - Artificial Pancreas with CGMS - Vigilant
Vigilant™ is a companion to monitoring that analyzes blood glucose data and provides feedback about daily patterns of hyperglycemia, hypoglycemia, glucose variability, and test frequency, as well as patterns indicative of increased risk of severe hypoglycemia in the next 24 hours. It is designed to provide concise messages prior to periods of risk so that users can take action to improve their glucose control. It also includes a list of avoidance options that could help people lessen the risk of a severe low. The Hypo Risk Indicator is part of a suite of pattern recognition tools included in Vigilant™, a smartphone-based companion to monitoring that alerts people with diabetes in advance of periods of risk and provides glanceable summaries of diabetes control. See Item #1.
Newsflash: New Way to Classify Types of Diabetes Proposed
Newsflash: FDA Approves Lilly’s Humulin® R U-500 KwikPen®
Test Your Knowledge
Mrs. O’Doole is a 34-year-old of Irish descent. She works as a 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.
Based upon her medical history and physical, you believe it would be prudent to screen Mrs. O’Doole for type 2 diabetes. You discuss your recommendations with her and she agrees be tested. The lab returns a fasting plasma glucose (FBG) of 112 mg/dL. You share these results with your patient and inform her that, while only mildly elevated, she has impaired fasting glucose.
What is the best choice for initial management of Mrs. O’Doole’s prediabetes? Follow the link to respond.
Fact: Is Breakfast the Most Important Meal of the Day?
Last week I had a chance to interview Dr. Mark Mattson who is the senior investigator and chief of the Laboratory of Neurosciences and chief of the Cellular and Molecular Neurosciences Section at the NIH. In an upcoming issue, we will be providing that live interview about intermittent fasting and how it might help those with diabetes. But I wanted to share with you two questions that I asked him in relation to the topic of intermittent fasting.
Who or how was it decided that everyone should eat 3 meals a day?
There is evidence that the 3 meals/day routine began during the early period of the agricultural revolution when people were working hard on the farms every day. They undoubtedly had a high calorie requirement to support their high-energy expenditure (e.g., 4,000 – 5,000 calories/day). Eating upon waking, then eating while taking a work break mid–day, and then eating in the evening at the end of the work day was presumably the most efficient way to eat and facilitated socializing and discussions of plans for work etc. Nowadays most people have a low calorie requirement because they do not expend much energy on physical labor (e.g., 2,000 calories per day).
How do you answer those who say that breakfast is the most important meal of the day, as it gets your metabolism moving?
The notion that breakfast is an important meal came from poorly designed studies, often supported by the breakfast food industry, for which the data were not interpreted properly. For example, dividing school kids who normally eat breakfast into two groups (no breakfast or breakfast) and then evaluating their behavior right before lunch time. Of course, if a kid normally eats breakfast and then does not eat breakfast one day it affects their behavior. However, if the kid normally did not eat breakfast, then his/her behavior would not be altered by skipping breakfast….Dr. Mark Mattison
— Steve Freed, R.Ph and Publisher
Watch for Dr. Mattison’s article and video I\interview in next week’s issue #818.
Safety and efficacy, adaptive control algorithm to be tested in U.S. and Europe.
β-cell centric classification of diabetes puts focus on single common denominator of all types.
New pen may improve glycemic control in people with severely insulin-resistant diabetes.
Current black box warning may be overstating the kidney risk.
New nutrition recommendations filled with numerous changes.
Surgery could lower patients’ development of future medical issues.
Quote of the Week!
“In order to succeed, we must first believe that we can.”
…Nikos Kazantzakis
Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletter:
Javeria Fayyaz, LECOM College of Pharmacy
Sabair Pradhan, University Of South Florida College of Pharmacy
Samantha Ferguson, FAMU College of Pharmacy
Your Friends in Diabetes Care
Steve and Dave
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