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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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