Frequency of Blood Glucose Testing in Type 1's: How Often is Enough?
"Good diabetes control can be achieved in routine diabetes care with flexible intensified insulin therapy based on continuing patient education."...
Obesity and Hypertriglyceridemia Increase Risk for Diabetic Neuropathy
Obesity and hypertriglyceridemia are significant risk factors for diabetic neuropathy independent of glycemic control....
FDA Advisory Panel Votes to Remove Avandia's Highly Restrictive Label
A panel of FDA advisers has voted to ease restrictions on access to Avandia (rosiglitazone), a past blockbuster drug brought low by reports that it increased the risk of heart attacks....
ACP: New Recommendations Regarding Blood Glucose Control
Intensive insulin therapy leads to increased risk of hypoglycemia in ICU patients without any added benefit....
Major Depression Associated with Increased Risk of Severe Hypoglycemia
A prospective study finds an increased risk in time to first severe hypoglycemic event and subsequent hypoglycemic events in diabetic patients with depression....
Candesartan and Pioglitazone Demonstrate Anti-inflammatory Properties
The use of the ARB, candesartan, and the oral anti-diabetic drug, pioglitazone, not only improved blood pressure and HbA1c levels, but serum levels of inflammatory proteins were reduced in type 2 diabetes patients....
ADA/JDRF Type 1 Diabetes Sourcebook, Excerpt #3: Adjunctive Therapies, Part 2 of 3
Anne Peters, MD, and Lori Laffel, MD, MPH, editors
Jane Lee Chiang, MD, managing editor
Sleeping-in Associated with Poor Glycemic Control
Each hour delay in mid-point sleep on free days was associated with a higher HbA1c of 2.5%....
Nutritional Effects on Measurement of Insulin Sensitivity
Partial replacement of carbohydrates with unsaturated fat may improve insulin sensitivity in a population at risk for cardiovascular disease....
AACE: Why Physicians Delay the Start of Insulin in Type 2 Diabetes Patients
The perception that insulin therapy may be too burdensome for patients has led primary care physicians to delay the use of insulin therapy in patient with type 2 diabetes....
Clarity in Insulin Coverage Orders
From our partners at the Institute for Safe Medication Practices (ISMP):
ISMP: IV Insulin Administration
From our partners at the Institute for Safe Medication Practices (ISMP), this week we have a review of IV Insulin Administration and two examples of what can go wrong when the correct procedures are not adhered to.
Wrong-Drug Errors Associated with Insulin Products
This week's Disaster Averted comes courtesy of ISMP.
There are numerous case reports in the literature that discuss the issue of wrong-drug medication errors with insulin products due to similarities in the...
Hypoglycemia Patient Questionaire, Treating Hypoglycemia, and Hypoglycemia Classification
A task force report by the ADA and Endocrine Society have updated hypoglycemia categories, providing a new way to classify hypoglycemia in the absence of blood glucose readings and to help customize diabetes treatments for hypoglycemia.
ISMP: Updating Your High-Alert Medication List
Because insulin is at the top of the "High-Alert Medication List," we are presenting this updated article from our partner at ISMP (Institute for Safe Medication Practices).
Joslin's Diabetes Deskbook, Updated 2nd Edition, Excerpt #30: Macrovascular Complications, Part 2
Richard S. Beaser, MD
Michael Johnstone, MD
Letter from the Editor #668:
This week we are sharing a plea from the American Association of Clinical Endocrinologists (AACE) for medical professionals and diabetes patients to urge members of Congress to pass the National Diabetes Clinical Care Commission Act. This...
Diabetic Emergencies, Diagnosis and Clinical Management: Sick-Day Rules in Diabetes, Case Studies
Konstantinos Makrilakis, Nikolaos Katsilambros
Insulin Pump Trainers and Training
An insulin pump trainer who worked with a pump company recently trained one of our patients in his home.
ISMP: A Clinical Reminder about the Safe Use of Insulin Vials
This feature article by our partner in diabetes safety, the Institute for Safe Medication Practices, summarizes the risks of insulin pen use in hospitals, the crucial importance of proper training for a safe transition to the use of insulin vials...
Joslin's Diabetes Deskbook, Updated 2nd Ed., Excerpt #27: Physical Activity for Fitness, Part 4
Richard S. Beaser, MD,
Edward S. Horton, MD and
Catherine A. Mullooly, MS, RCEP,...
Changing Doses Can Be Confusing
A woman with newly diagnosed type 2 diabetes mellitus and also on blood pressure and anti-lipid medication was given prescriptions for: glucophage 500mg QD for one week, and then an increase to two 500mg tablets the second week.
Your Patients' Guide to Better Office Visits
Psychology in Diabetes Care, 2nd Ed., Part 11
Edited by Frank J. Snoek and T. Chas Skinner
Diabetes in Adolescents
United States of Diabetes Report
You can use the information in this report to provide evidence for your ...
Editor's Note #65: Diabetes in Adolescents -- Familial Interventions
When we talk about adolescents and diabetes we usually spend a lot of time with the family as well as the patient. Too often the parents give commands rather than provide support so attempting successful management of glucose levels often...
Psychology in Diabetes Care, 2nd Ed., Part 10
Edited by Frank J. Snoek and T. Chas Skinner
Diabetes in Adolescents
Editor's Note: New Homerun Slides on CVD
Over the past weeks we have shared some great slides on Advanced Glycation End-products, and there's a lot linking these...
Diabetes Disaster Averted #60: Helping Patients Decipher Nutrition Labels
I had a patient who came in for instruction on carbohydrate counting in order to dose his insulin based on his carbohydrate intake. I instructed him on the use of food lists and food labels. When the patient returned...
Formula for Converting A1c to eAG
Converting your patients A1c result to their average blood glucose will give them a better understanding of their diabetes control. Most patients do not have a true understanding of what their A1c result means to their overall ...
Editor's Note: Anti-inflammatory Steroids and "Hypoglycemia"
There has been a shortage of methylprednisolone and prednisone dose packs available in pharmacies lately and this week's Disaster Averted deals with what happens when patients get their anti-inflammatory steroids in a bottle instead of...
Managing Clinical Problems in Diabetes, Case Study #13: Gestational Diabetes
Edited by Trisha Dunning AM, RN, MEd, PhD, CDE, FRCNA and Glenn Ward MBBS, BSc, DPhil (Oxon), FRACP, FRCPath
Diabetes Disaster Averted #42: Anti-inflammatory Steroids and "Hypoglycemia"
I recently had a 55 year old gentleman who started experiencing severely low glucose readings and called me on the phone. We went over his food, his activity and his diabetes medications and all seemed correct....
Editor's Note: The Value of Glucagon Kits; Retinopathy Homerun Slides; and Fear of Insulin
Many times our patients get a Glucagon Kit when they start on insulin and since most patients are taught to only use the injection if they are unconscious, they never use it. However, in this week's Diabetes Disaster Averted, the use of part...
Managing Clinical Problems in Diabetes, Case Study #12: Psychological Issues and Quality of Life
Edited by Trisha Dunning AM, RN, MEd, PhD, CDE, FRCNA and Glenn Ward MBBS, BSc, DPhil (Oxon), FRACP, FRCPath
Mrs. MJ was referred to a diabetes centre by her GP....
To Stretch or Not to Stretch with Diabetes?
By Sheri Colberg,...
Worst Cocktails for Blood Sugar - Handout
Do you know how your favorite libation ranks?
Which are the...
Letter from the Editor: ADA Preview
Airfares are at an astronomical level this year, hotels in San Diego cost more to stay in than the national debt of most major countries, and we know that many of you can't get away for 4 or 5 days anyway to attend...
Managing Clinical Problems in Diabetes, Case Study #9: Mrs. MS
Edited by Trisha Dunning AM, RN, MEd, PhD, CDE, FRCNA and Glenn Ward MBBS, BSc, DPhil (Oxon), FRACP, FRCPath
Managing Clinical Problems in Diabetes, Case Study #8: Mr. TE
Edited by Trisha Dunning AM, RN, MEd, PhD, CDE, FRCNA and Glenn Ward MBBS, BSc, DPhil (Oxon), FRACP, FRCPath
Managing Clinical Problems in Diabetes, Case Study #5: Mrs. AV
Edited by Trisha Dunning AM, RN, MEd, PhD, CDE, FRCNA and Glenn Ward MBBS, BSc, DPhil (Oxon), FRACP, FRCPath
Managing Clinical Problems in Diabetes, Case Studies, Part 3
Edited by Trisha Dunning AM, RN, MEd, PhD, CDE, FRCNA and Glenn Ward MBBS, BSc, DPhil (Oxon), FRACP, FRCPath
Managing Clinical Problems in Diabetes, Case Studies, Part 2
Edited by Trisha Dunning AM, RN, MEd, PhD, CDE, FRCNA and Glenn Ward MBBS, BSc, DPhil (Oxon), FRACP, FRCPath
Diabetes Disaster Averted #31: Injection Site Technique
I saw an obese long-term person with Type 2 diabetes who was experiencing widely fluctuating BGs and had had two hospitalizations within the previous six months, one for a BG of 28mg dl and one for an infested hair follicle (BG 413 mg/dl in...
Editor's Note: New Text Case Study, the Right Syringe, and More
A few weeks ago an endocrinologist that I work with let me look at an article he had cut from a medical journal: the gist of the article was how the use of instant references on handheld devices and tablet computers was hurting the clinical...
Managing Clinical Problems in Diabetes, Case Studies, Part 1
Edited by Trisha Dunning AM, RN, MEd, PhD, CDE, FRCNA and Glenn Ward MBBS, BSc, DPhil (Oxon), FRACP, FRCPath
Th
How to Best Manage and Prevent Exercise Low Blood Sugars
By Sheri Colberg, PhD
What is Your Quality of Life Number?
What is a 6% A1c? What does it mean? How does it...
Editor's Note:
This week Steve finishes up his Homerun Slides on the Cost-Effectiveness of Treatment Strategies for Comorbid Diabetes and Dyslipidemia, by showing how Shared Medical Appointments can actually improve care.
SMA's definitely are the...
Letter from the Editor: New Partnership with ISMP and Glucocard Vital Meter
For almost 11 years Steve and I have been sending you this newsletter, trying each week to make an impact on diabetes care with the hope that the information we are communicating is beneficial to you. During this time we have leveraged our...
Diabetes and Healthy Eyes Toolkit
New Toolkit for Community Health Workers to Educate People...
Letter from the Editor: Not Getting Caught Up in the Numbers and an Investigation into rhGH
Our first item, Predicting Diabetes: Using the Fasting Glucose, A1c, or OGTT, this week looks at the best way to diagnose diabetes...
Tool for your Practice: QuickChek™ Record Book
QuickChek™ Record Book
Blood glucose...
Handheld Applications for Diabetes Management
by Janine Manning, PharmD Candidate
LECOM School of Pharmacy
New technological advances over the past decade have led to extraordinary changes for those living with diabetes. Technology has allowed us to go from...
Tool for Your Practice: A1c to mg/dL Conversion Chart
A1c to mg/dL Conversion Chart
New more accurate formula used to convert A1c to average blood glucose. Provide this chart to your patients so they can convert their A1c results to an average blood glucose.
A Life of Control: Stories of Living with Diabetes
by Alan L. Graber, Anne W. Brown, Kathleen Wolff
Are Exercise-Induced Low Blood Sugars Making You Fat?
Tool for your Practice: QuickCheck™ pdf
QuickCheck™ (pdf) - Nipro Diagnostics
Blood glucose monitoring only has...
A Year of Diabetes Research 2010
Prevention, therapy and complications are the keystones for diabetes research. It would be impossible to cover all of the developments in just one feature. So here is a brief summary of some of the best for 2010.
Diagnosis and Management of Type 2 Diabetes, 10th Edition, Ch 13-Pt 4
Assessment of the Treatment Regimen, Part 4
Letter from the Editor:
This week we have an article about the use of glycated albumin for monitoring fluctuating and poorly controlled Type 2 diabetic patients. The authors...
Diagnosis and Management of Type 2 Diabetes, 10th Edition, Ch 13-Pt 3
Assessment of the Treatment Regimen, Part 3
Tool for Your Practice: Challenges and Opportunities to Control Diabetes
Challenges and Opportunities to Control Diabetes
This new report,...
Editor's Note: Balancing Weight Loss and Glucose Control
Weight loss and glucose control-- the Holy Grail of diabetes care. We see it over and over again. Obesity often leads to diabetes and then the battle begins: get the weight down, keep the A1c down, be more aggressive managing both and reduce the...
Diagnosis and Management of Type 2 Diabetes, 10th Edition, Ch 11-Pt 2
Pramlintide Therapy
Diabetes Disaster Averted #4: Patient Query Helps to Catch Dosing Error
I was working as a diabetes nurse in a hospital when a patient I was seeing asked me to find out why she experienced two recent hypoglycemic episodes. She came into the hospital...
Letter from the Editor: Getting A1c Strips, Jumpstarting Your Metabolism
This week there is a lot of focus on glucose monitoring. We have a new study showing the value of vigilant monitoring to successfully manage glycemic control in patients with Type 2 diabetes, and Pamela Kushner, MD, has the results of a study...
Diabetes Disaster Averted #2: Insulin Pump Mystery
"One of our pump-using patients reported a sudden increase in blood glucose lasting several days. No ketones were present, but the blood glucose was chronically elevated (300 mg/dl plus). Changing infusion sets didn't fix it. Rotating to...
Managing Type 2 Diabetes: Balancing HbA1c and Body Weight
Annie A. Mavian, DO; Stephan Miller, PhD; and Robert R. Henry, MD
Abstract: Most patients with type 2 diabetes present with comorbid overweight or obesity. Reaching and maintaining acceptable glycemic control is more difficult in...
How to Obtain Appropriate Type 2 Diabetes Control in the First 180 Days of Treatment Initiation
Louis Kuritzky, MD; Benjamin J. Epstein, PharmD, BCPS; and Frank Lavernia, MD
Abstract: Good control of diabetes provides meaningful microvascular risk reduction; yet, patients with type 2 diabetes mellitus commonly languish at...
Hyperglycemic Emergencies
Lana Kravarusic
Doctor of Pharmacy Candidate, University of Florida
Intermittent High-Intensity Exercise: Higher Now, Lower Later?
By
Bayer's DIDGET(TM) Blood Glucose Meter
Reviewed by Dave Joffe, CDE, FACA. Editor-in-Chief
Bayer's CONTOUR® USB Blood Glucose Monitoring System
Reviewed by Dave Joffe, CDE, FACA, Editor-in-Chief
and Alexander Brown, PharmD Candidate Florida, A & M...
Essential Oils for the Management of Type 2 Diabetes
Ivory A. Gordon, Pharm.D....
Testosterone Gel Improves Diabetes in Men with Low Levels
News from the British Endocrine Society meeting
MANCHESTER, England -- Topical testosterone replacement reduced insulin resistance and glycated hemoglobin in men who were deficient in the hormone and at ...
How to Easily Reap the Health Benefits of Physical Activity
By
It's as Easy as 1-2-3 Injections a Day -- Or Is It?
Dave Joffe, BSPharm, ...
The Weight Loss Plan for Beating Diabetes
The 5-Step Program That Removes Metabolic Roadblocks, Sheds Pounds Safely, and Reverses Prediabetes and Diabetes
Five Things Every Person with Diabetes Should Know About Exercise
by
Effective Dietary Practices of Active People with Diabetes: Part 2 (Supplementing with Carbohydrates)
Effective Dietary Practices of Active People with Diabetes:
Part 2 (Supplementing with...
Effective Dietary Practices of Active People with Diabetes: Part 1 (Importance of Carbohydrates)
By Sheri Colberg, Ph.D.,FACSM
As a physically...
Glucose Targets Are the Least of Your Worries
Last week at The American College of Physicians Internal Medicine 2009 Conference everyone in hospital medicine seemed excited about inpatient glucose control. The NICE-SUGAR study drove interest and in a session on Friday morning Dr. Gregory A....
Using the A1c Test to Diagnosis Diabetes
We do a fasting and it looks good, we do a 2 hour glucose test and it is fine but then the A1c comes back at 7%: does the patient have diabetes or not? Randie R. Little, Associate Professor University of Missouri, Director Diabetes Diagnostic...
Insulin Use and Exercise, Part 1: Faster and Intermediate-Acting Insulins
When you don’t have diabetes and you start any activity, your body increases the release of glucose-raising hormones to prevent falls in your blood glucose levels. At the same time, your pancreas releases less insulin during exercise. But...
Abbott Finds the Answer and it’s the Cat’s Meow
Timing is everything. This week, dLife talks about pets and diabetes and David Kliff, Publisher of Diabetic Investor, has found out that a major meter company is going to take over the market. Click here to read Abbott Finds the Answer and...
Preventing Hypoglycemia During and After Exercise
Last time Sheri Colberg, Ph.D., FACSM, gave us tips on how to deal with Exercise-Induced Hypoglycemia, this week she takes it a step further by teaching us how to Prevent Hypoglycemia During and After Exercise.
Dealing with Exercise-Induced Hypoglycemia
Too often our patients who are very active start to decrease their participation in sports and other physical endeavors. Frequently, this is because they are experiencing hypoglycemia and have no idea how to prevent this from happening. Sheri...
Seniors in 'Gap' cut back Medicines
Pharmacists are always telling me that patients don’t fill prescriptions when they hit the doughnut hole in Medicare Part D coverage. This week Yuting Zhang, Assistant Professor Of Health Economics at Pitt's Graduate School of Public Health,...
New Test For Diagnosis of Diabetes and Pre-Diabetes
The ADA and other organizations will be announcing the guidelines on how to use the A1c test to diagnose diabetes. The test that has been used by most doctors is the fasting blood glucose test. The problem with the fasting blood glucose is that...
Exercise and Hypoglycemia: Their Effect on Hormonal Responses
Often our patients with diabetes have unexplained hypoglycemia and there seems to be no rhyme or reason as to why. Sheri Colberg, Ph.D., FACSM has the latest research on what happens to cause this. Read Exercise and Hypoglycemia: Their Effect on...
The Glucose – CVD Connection: The Search For The Missing Link
There is a new study out trying to show the link between intensive glycemic control and reductions, if any, in cardiovascular endpoints. The VA Diabetes Trial of 1,800 patients, showed like other, larger trials recently published, that there was no...
How Training Affects the Fuels Your Body Uses and Insulin Action
Last week I was on the phone with Rick Philbin, from Animas. Rick is a type one patient who is also active in DESA. A few years ago we crowned Rick the world’s most fit diabetes sales rep. When you check out his insulin use it is almost...
Timing of Exercise and Your Insulin Levels
Timing of Exercise and Your Insulin Levels By Sheri Colberg, Ph.D., FACSM, is a must read for everyone. Not only does this feature apply to insulin dependent patients, but the information is for all patients whether they have diabetes or not.
Tai Chi for Diabetes
Dr. Paul Lam, is a practicing physician and Tai Chi master. He has written a new book “Tai Chi for Diabetes” and our current intern Irene Lelekis, Doctor of Pharmacy Candidate University of Florida College of Pharmacy, has experienced...
Diabetic Athlete’s Handbook: Your guide to peak performance
Sheri Colberg Ph.D. has written a new book based on her experiences as an athlete and diabetes patient. The Diabetic...
Why Your Body Always Uses Carbohydrate during Exercise
We seem to spend so much time with our overweight Type 2 patients that we forget about the patients that seem to be doing everything right. They eat right, they exercise and they still have problems. Dr. Sheri Colberg, Ph.D., FACSM works with these...
“Because The Light’s Better Here!”
Why Focusing On Intensive Glucose Control With Drugs Alone Is Counterproductive
Diabetes and Pregnancy: Twice as important
Pregnancy is a wondrous and exciting time. It’s a time of change, both physically and emotionally. With the proper attention and prenatal medical care, most women with diabetes can enjoy their pregnancies and welcome a healthy baby into their lives.
Clinical Use of 1,5-Anhydroglucitol for Identifying PPH, Part 3 of 4
With this week's Homerun Slides, we have the third slideset of a four part series which we are...
Core Defects of Type 2 Diabetes, Part 3 of 4
With this week's Homerun Slides, we pick up again on our Core Defects of Type 2 Diabetes series...
Challenges in Identifying Postprandial Hypoglycemia, Part 2 of 4
With this week's Homerun Slides series, we present the second set of a four part series which...
Diabetes Update, Part 3 of 3
In this week's series of Homerun Slides, we review the insulin analogs, the principles of...
Diabetes Update, Part 2 of 3
In this week's Homerun Slides series, we go over why there is so much interest in the...
Achieving Glycemic Control in the Hospital Setting, Part 4 of 4
In this week's set of Homerun Slides, we wrap up this short series on glycemic control in...
Achieving Glycemic Control in the Hospital Setting, Part 3 of 4
In this week's set of Homerun Slides, our topics include IV Insulin Protocols, Considerations when...
Achieving Glycemic Control in the Hospital Setting, Part 2 of 4
In this week's Homerun Slides, we present the second of four parts on glycemic control in...
Achieving Glycemic Control in the Hospital Setting, Part 1 of 4
In this week's set of Homerun Slides, we present the first of four parts on the issue of glycemic...
Glucose Monitoring - Why Monitor?
In this week's set of Homerun Slides, we explore the question of why patients are so reluctant to...
Hypo and Hyperglycemia, Part 1 of 4
This week we begin a new Homerun Slides series covering Hypo and Hyperglycemia...
Diabetes Mellitus 101 for Medical Professionals, Part 2 of 9
In this week's set of Homerun Slides,...
Incretins, Part 3 of 7
This week we continue our six part series on Incretins with Homerun Slides...
Pathophysiology in the Treatment of Type 2 Diabetes: Newer Agents, Part 4 of 5
This week we continue with Part 4 of our series of Homerun Slides on...
Cost-Effectiveness Strategies, Part 3 of 4
The ACE/AACE road map for the achievement of...
Diabetes Microvascular Complications, Part 2 of 2
The exact mechanism of extracellular matrix accumulation and...
Insulin Resistance, Part 2 of 3: Inflammation Markers
Plasminogen is an acute phase protein and precursor to plasmin, which...
Glycemic Disorders Part 2 of 2
Blood glucose levels can be evaluated using one of several measures: random...
Homeostatic Model Assessment
This week,...
Diabetes Therapy in the Elderly
Screening for Diabetes and Pre-Diabetes
Patients who...
