March 5, 2016 : Issue #823

• Can Testosterone Decrease Your Cardiac Biomarkers?
• Personalized Text Messages Improve Physical Activity For Diabetes Patients
• Tendon Pain Linked to Diabetes
• Younger Children At Risk of Aggressive Form of Diabetes
• Factors Impacting Diabetes Remission and Glycemic Control Following Bariatric Surgery
• Featured Writer: Dr. Sheri Colberg, Ph.D., FACSM
  • Why People Stop Exercising (and How You Can Get Them Restarted)

Ever since GLP-1 analogs have been available, there have been a lot of worries about cardiovascular problems. Part of this was brought on by Dr. Steven Nissen’s full frontal attack on the TZD’s (later proven to not be true). His angry commentary on the cardiovascular risks of diabetes drugs put a damper on a lot of physicians using the GLP-1 analogs, and billions of dollars have been spent to study the effect of this class on cardiovascular health.

This week the results of the LEADER Trial were published: a 9100 patient, 5-year study of the use of  liraglutide (a once-daily GLP-1 analog) and cardiovascular risk. Click here to see the results, and then you can decide how best to treat your patients.

Announcements:

Diabetes Summit 2016

DIC Publisher Steve Freed will be attending the GTCbio 2016 Diabetes Summit, to be held April 25-27, 2016 in Boston, MA.  This unique event encompasses the drug discovery and partnering aspects of diabetes in two individual conferences that take place concurrently. Click here for more information.

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, March 6, 7PM ET

From dLife.com: “dLife demystifies different types of insulin, from animal to analog. Plus, an extreme diabetes makeover, and a slow cooker favorite from the dLife kitchen.” 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

Are you pro or con for a single-payer system – Medicare for all? Follow the link to share your opinion!

IBM and Medtronic team up to produce an app to predict hypos, which is 80-90% accurate. The app uses the IBM Watson supercomputer – the same one that won “Jeopardy,”

Victoza LEADER trial of 9,000 adults with type 2 diabetes found that drug significantly reduced the risk of heart attack or stroke.

Mrs. Hunter is a 36-year-old African-American who comes to your office for her annual wellness exam. She is overweight (BMI 27 kg/m2), but is otherwise healthy. She jokes that she “just can’t seem to lose that extra baby weight” after giving birth 3 years ago. However, her daughter recently started preschool, so she has been able to go to her new gym several times per week. In fact, one of the added bonuses of her membership is the free, weekly nutrition and exercise support groups. In addition to her routine labs, you order an A1C, which comes back elevated at 7.1%. This measurement is confirmed several days later.

Based on Mrs. Hunter’s profile, what would a reasonable next step be?

Select one answer:

A. Encourage lifestyle modifications and start metformin with an A1C target of less than 7.0%
B. Encourage lifestyle modifications and start metformin with an A1C target of less than 6.0%
C. Encourage lifestyle modifications and do not initiate drug therapy at this time
D. Encourage lifestyle modifications and start metformin and a sulfonylurea

Are you correct? Follow the link to see!

Chinese adults who returned for three follow-up visits between 2006 and 2011, showed FPG levels in winter increased by a mean of 11.99 mg/dl (0.31 mmol/L), compared with autumn levels, with a greater difference seen among those with diabetes.  Higher levels were also observed in extreme ambient cold and hot temperatures.

Data was analyzed from 49,417 adults participating in the Kailuan study, a prospective, community-based analysis of current and retired employees of a China-based coal mining company (77.6% men; 9.5% aged 65 years; 3.1% with BMI 32 kg/m²; 7.9% with history of diabetes). City residents receive free biennial health examinations, including questionnaire assessment, blood work, urinalysis and biochemical tests. Each study participant returned for three follow-up visits between 2006 and 2011.

Researchers downloaded daily meteorological data between 2006 and 2011 from the China Meteorological Data Sharing Service System and used generalized additive mixed models to examine the effects of temperature and seasonality on FPG levels while controlling for sex, age, BMI, diabetes status, exercise activity, alcohol intake and other variables.  Researchers found that FPG levels were higher in winter and spring than that in autumn and summer; FPG levels were highest in winter and lowest in autumn for all participants.  When compared with autumn levels, FPG levels in winter increased by a mean of 11.98763 mg/dL (0.31 mmol/L )(95% CI, 0.28-0.33). The difference was greater in participants with diabetes, according to researchers (P < .05), but there were no between-group differences based on sex or age. The association between temperature and FPG levels was U-shaped. For all participants, the mean change in FPG levels were associated with extreme cold temperature 440F (6.7°C), moderate cold temperature 36.30 (2.4°C), moderate hot temperature 750 (23.7°C) and with extreme hot temperature 82.60 (28.1°C), in comparison with the threshold temperature 650 (18.1°C). “Understanding the seasonality in markers, such as lipids, fibrinogen, blood pressure and FPG, is helpful to explore the reason for seasonality in the morbidity and mortality of diseases,” the researchers wrote. Accumulating evidence has shown that FPG, lipids, fibrinogen and [BP] usually have a tendency to be higher in winter than in summer. Such seasonal variability might be driven from cold air temperatures, which increase activation of the sympathetic nerve system and secretion of catecholamine: DOI:  http://dx.doi.org/10.1016/j.diabet.2016.01.002

Men with type 2 diabetes and cardiovascular risk focus of study.

Study finds positive feedback can go a long way to reinforcing positive health habits.

Aggressive or inappropropriate exercise may be a factor in connection between type 2 diabetes and tendonitis.

Research finds differences in type 1 diabetes in children versus teens.

Study finds remission rates of diabetes in patients who undergo weight loss procedure.

Ever go to a fitness facility in January and then back in April? The difference in the number of people working out is tremendously fewer, even just a few months after most of them were all gung-ho about getting into shape in the new year. Why does this happen?

Quote of the Week!

“You must do the things you think you cannot do.”

…Eleanor Roosevelt

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

Jimmy Tran,  LECOM College of Pharmacy

Adaisha C. Rutledge,  FAMU College of Pharmacy

Samanatha Ferguson,  FAMU College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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USA
www.diabetesincontrol.com