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Oct. 8, 2016

dave

This week the take home message asks us to change from “start low and go slow,” to “be aggressive not repressive.” More and more documentation shows the value of adding newer classes of medications sooner to get our patients to target. Part of this comes from the sheer acknowledgement that our patients are developing diabetes at a younger age, and they have years longer to develop complications. And another part is the increased desire to get patients to goal to maximize ratings. Whichever one you think is more likely is okay, because the end result should better care.

We start off with the combination of SGLT-2 inhibitors with a long acting GLP-1 Analog, then we look at the combination of basal insulin along with another GLP-1 analog. And just to point out exactly how bad of a job we do of intensifying therapy quickly, we have a study with 11.000 patients that looked at intensification, and you have to see the results to determine if we are doing a good job.

Looking ahead: Monday, watch for our special issue all about how “The Biological Clock” can impact blood glucose control.

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We can make a difference!

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Dave Joffe, Editor-in-chief