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High Triglycerides

Which of the following is true regarding the presentation and diagnosis of hypertriglyceridemia?

A. Hypertriglyceridemia is usually asymptomatic until triglyceride levels are greater than 500-900 mg/dL.
B. When triglycerides are elevated, blood glucose and A1c should be checked to rule out uncontrolled diabetes.
C. Second-degree relatives should be screened for hyperlipidemia.
D. The use of oral contraceptives, beta-blockers, and thiazide diuretics have been linked to decreased plasma triglyceride and very low-density lipoprotein (VLDL) levels.

Follow the link for the answer.

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Preferred A1C

If you could have any A1c result for yourself what would that be?

- Below 8%
- Below 7%
- Below 6%
- Below 5%

Follow the link to see how you and your colleagues compare.

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When Family Members Are HCPs

Male, 68 years of age, type 2 diabetes, Italian, on long-acting insulin and GLP-1. Basal glucose levels are within target as are most post-prandials except every night after dinner. We have talked several times about lowering carbs, which he has done during the daytime, but has difficulty cutting back on dinner meal. We had in the past discussed taking rapid-acting insulin for meals, but he refused. After two weeks, patient sent me his CGM results. Even he started getting concerned about his evening post-prandial levels. Rapid-acting insulin added before dinner and post-prandials are now in target range. He has not once complained about taking the rapid-acting insulin before dinner.

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Linda Parks 2018 Complete Interview

Linda Parks, Certified Diabetes Educator, has worked in diabetes care for over 25 years, both as a clinician and in the diabetes technology industry. Her passion is in bringing new technologies to market that make a difference in the lives of people living with diabetes and their loved ones.  She believes it is not just the technology, but the data from the devices translated into actionable insights that bring significant changes. Linda has held positions at Abbott Diabetes Care, Tandem and Senseonics and is currently the Director, Clinical Development & Research at Glooko, Inc.  She is a Certified Diabetes Educator and holds a MS in Nursing Science and Healthcare Leadership from the Betty Irene Moore School of Nursing, University of California, Davis.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #150: Glucose Toxicity Part 6

Clinical significance of glucose toxicity: After diagnosis of type 1 diabetes, initiation of insulin therapy induces partial clinical remission in ∼30% of the patients during the first year. This honeymoon period is characterized by normoglycemia, recovery of endogenous insulin secretion, and by improved insulin sensitivity. Although correction of several alterations secondary to insulin deficiency, such as increased counterregulatory hormone secretion, hyperosmolarity, acidosis, electrolyte changes and high free fatty acids could contribute to normalization of insulin secretion and sensitivity, reversal of glucose toxicity may also be of importance for the occurrence of remission.

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