February 6, 2016 : Issue #819

• Shifting Paradigm in Diabetes Treatment – An Interview with Dr. Vinik
• AACE/ACE 2016 Update on Standards of Medical Care in Diabetes
• Alogliptin Prevents the Progression of Atherosclerosis in Type 2 Diabetes Patients
• D2 – Dementia and Diabetes
• The Effects of Glucose Lowering Agents on Mortality Rate
• GLP-1 Agonist: the Potential New Replacement
• Featured Writer: Dr. Sheri Colberg, Ph.D., FACSM
  • Just Exercise Harder for Less Time, or Not?

The 2016 professional cycling season has started, and this week Team NovoNordisk is competing in the Tour of Dubai. This race brings together professional cycling teams from all over the world and many of the top riders, including 4 former Tour de France winners. As you know, all the TNN riders have type 1 diabetes. Through the first 3 stages the team has 3 riders in the top 50, and a couple of them are only a little more than 5 minutes out of the lead after 320 miles of riding. We will have updated results for you next week and some feedback from some of the riders.

While these professional riders are in fantastic condition and  increase their endurance levels with interval trainings, most of our patients struggle just to get in some physical activity to help manage their diabetes. This week, Dr. Sheri Colberg has a special feature on using interval training, and whether that will actually help our patients to weight loss and better glucose control.

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, February 7, 7PM ET

From dLife.com: “dLife looks at breaking insulin barriers in type 2 treatment with Dr. Steve Edelman. Plus, dLife explains most important number in your diabetes care – the A1C.  And, how a pastor’s wife started a movement in faith-based healthcare.” 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

What is the most important aspect in treating diabetes — lowering blood sugars or protecting the heart? Follow the link to respond!

Got gestational diabetes? This App helps you track all of the factors that keep your blood sugar balanced during and after your pregnancy. Log nutrition and exercise information as well as oral medications and insulin.

Doximity, the largest medical professional network in the US, is now available for Apple Watch. Read, reply and save precious time on messaging and faxing right from your wrist.

Long-acting Tresiba® U-200 now available in the United States for adults living with diabetes.

(Continued from Question #816, Question #817 and Question #818 )
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 to 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. She was started on lifestyle modifications plus dietary modifications, and exercise for weight loss.

At a follow-up appointment 6 months later, Mrs. O’Doole tells you despite good intentions, she has not been able to adhere to any meaningful lifestyle changes, in fact she has gained 5 pounds. At this time, her repeat fasting plasma glucose shows FPG 138 mg/dL. After discussing management options with her, you decide the best management would be metformin and lifestyle modifications.

You discuss the benefits of lifestyle changes with Mrs. O’Doole and tell her that you are referring her to an exercise program specifically for individuals with type 2 diabetes. What schedule of exercise is recommended for patients like Mrs. O’Doole? Follow the link to answer!

Standing desks in classrooms could be an easy way to help make kids’ time in school less sedentary, a new research review suggests. The study team analyzed data from eight previously published papers and found, not surprisingly, that kids spent more time on their feet when these desks were used instead of traditional classroom furniture.  Standing desks were also linked to a decrease in sitting time of at least 62 minutes per school day. Reducing sedentary time among school-age children is important because inactivity is linked to a wide range of health problems including obesity and diabetes, and poor academic achievement and low self-esteem. For the current study, researchers focused on standing desks used in first through sixth grades.  The researchers concluded that, the long term use of these desks might result in reduction in sedentary behavior amongst children not just in schools but even outside the school environment.  Children may become more active overall and these changes in behavior may translate into better weight outcomes, improved ability to learn and pay attention and greater self-esteem.  Pediatrics, online January 22, 2016.

How SGLT-2 inhibitors can provide new approach over treatment centered on attaining glycemic control, intensive therapy.

New management recommendations for the treatment of type 2 diabetes.

New study suggests possible role for DPP-4 inhibitor in reducing CVD risk.

Uncontrolled blood glucose seems to increase the risk of brain troubles.

Metformin, sulfonylureas, and insulin show varied survival rates in patients with type 2 diabetes.

Could medication exhibit a much desired side effect with once weekly administration?

While interval training is routinely used by sports teams and athletes, is this type of training beneficial for most individuals with diabetes? It certainly saves time—who can’t fit in 10 minutes of exercise three days per week?—but would it benefit weight control in the average person?

Quote of the Week!

“Hope is being able to see that there is light despite all of the darkness.”

…Desmond Tutu

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

Jennifer Zahn,  University Of South Florida College of Pharmacy

Samantha Ferguson, FAMU College of Pharmacy

Jimmy Tran, LECOM College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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Ewing, NJ, 08628
USA
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