September 8, 2015 : DCMS #257

The diabetes newsletters and services have all been carrying articles about the artificial pancreas. There are three basic components to the device. There is a pump to deliver insulin and a pump to deliver glucagon, however, the “brains” of the system is the glucose reading device. Without the brains, then the other two components just work randomly with dangerous consequences. The reason that the whole idea of an artificial pancreas has been the development of reliable CGM (continuous glucose monitoring) devices. These devices have been helping patients for many years. During this time, the accuracy has gotten much better and the sensors last much longer. Our Senior Intern, Diana Jules, from the University of South Florida College of Pharmacy, got an advanced copy of a new book by Gary Scheiner, MS, CDE, Practical CGM, and she has prepared a concise Book Review for you to read.

In our Exclusive Interview, George Bakris, MD, explains microalbuminuria as a sign of kidney disease, how often to test for it, and how to see if you can prevent it, while our Homerun Slides look at the effect of some oral medications on insulin in the body. And Diabetes Disasters Averted, we see the importance of not only teaching a patient how to achieve glucose goals, but the importance of patience in the meanwhile.

Our Doctor of Pharmacy Candidate from LECOM College of Pharmacy, Diana Jules, has reviewed a new book from the ADA and found that it is a good read for you. See what she has to say.

Patient, type 2 diabetes and obesity, on basal/bolus insulin with an A1C of 10.7%. He was not following any particular meal plan, and was, for the most part, consuming a high carb diet.
Diabetes education was provided, including how carbohydrates affect glucose levels, lowering his carbs, and ideal target glucose levels. We told him we did not expect him to reach these levels right away, in fact we wanted to see how he adjusted to the change in diet without low glucose levels, so we recommended he decrease both his basal and bolus insulin, with clear instructions on how much insulin to take…

In this week’s Homerun Slides, we see how sulfonylureas, metformin and TZDs work in the treatment type 2 diabetes…

This week George Bakris, MD, explains microalbuminuria as a sign of kidney disease and how often to test for it. He also ponders the questions of how do you determine if the patient is at risk for nephropathy and what do you do if they are….