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Monthly Archives: February 2016

Diabetes Manager

Diabetes Manager is an all-in-one insulin calculator, carbohydrate database, favorites database, and diary. It is developed for people with type 1 diabetes who inject pre-meal fast or rapid-acting insulin.

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Question #821

Test Your Knowledge

Mr. Hernandez is an overweight (BMI 30 kg/m2), 45-year-old plumber of Hispanic heritage who arrives at your office for a first-time visit. He has not been to a physician during the last 7 years because he hasn’t always had health insurance and “doesn’t like going to the doctor.” However, he has been noticing lately that his vision seems a little blurry and he’s developed a red, itchy rash in his groin. He is a non-smoker and recalls being told a long time ago that he should eat a low salt diet, but he can’t remember why. On examination, his BP is 154/96 mm/Hg, and his pulse is 72, RR 22. His physical exam is notable for signs of a yeast infection in his groin. You order a CBC, Chem 12 panel and A1C to be drawn that day before he leaves. You advise him how to treat his skin infection. When you receive the results of the Chem 12 panel, it shows a random plasma glucose of 162 mg/dL. His A1C was 7.3%. You call Mr. Hernandez and ask him to return the next morning, before he has eaten, for additional labs. In this individual, you might order all the following labs EXCEPT urine ketones. Mr. Hernandez labs return and are notable for A1C 7.5, FPG 137 mg/dL, LDL-cholesterol 190 mg/dL, HDL-cholesterol 38 mg/dL and triglycerides 232 mg/dL. You discuss his lab results, his diagnosis and how to manage diabetes, and make referrals to the appropriate diabetes team clinicians. You start Mr. Hernandez on metformin, lifestyle modifications, an ACE inhibitor and a statin. What glycemic and blood pressure parameters are you looking to achieve for most individuals? A. A1C<7%, BP<130/80 mmHg B. A1C<7%, BP<130/90 mmHg C. A1C<7%, BP<140/80 mmHg D. A1C<7%, BP<140/90 mmHg Follow the link to respond!

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February 20, 2106

When the SGLT-2 drugs first came out, there was a big emphasis put on the UTI side-effect, and many prescribers were hesitant to try the class. This proved to be over-exaggerated and prescribers started using them. Further research showed that they could cause weight loss and lower blood pressure, and …

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Upcoming Event: GTCbio Diabetes Summit 2016

DIC Publisher Steve Freed will be attending the GTCbio 2016 Diabetes Summit, to be held April 25-27, 2016 in Boston, MA. This unique event encompasses the drug discovery and partnering aspects of diabetes in two individual conferences that take place concurrently: 9th Diabetes Drug Discovery & Development Conference Sessions include: Joint Session: Stem Cell Research …

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According to IMS prescribing data, all of the SGLT-2 inhibitor class drugs are experiencing growth. What is more important is that the 6-month adherence rate is higher than any other branded class. Part of this can be attributed to the 2-year free medication vouchers that all manufacturers offer. However, if …

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This past week, we had our 3rd endocrinologist retire since December. We have a metropolitan population of just under 3 million people, and now we are down to 17 endocrinologists — and 6 of them only take care of children. Eleven endos for 3 million people is just hard to believe. If …

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Diabetes Information Best Shared By Patients and HCPs Alike

Woman, 58 years of age, history of PCOS, prediabetes, strong family history of type 2 diabetes, cardiovascular disease and obesity. This patient lives a healthy lifestyle, including a lower carb meal plan, is very active, and keeps her weight down. Those interventions did not lower her A1C, so she educated herself and asked her NP/CDE if she should start metformin. This was about 20 years ago. Since starting metformin, A1C is in the 5.1-5.5% range. Patient regularly checks glucose, which was recently rising. A1C rose to prediabetes range again. Started on GLP-1 by NP/CDE. Patient then went to a new PCP who told her she should not be taking metformin or the GLP-1 because she does not have diabetes. Wanted to refer her to an endocrinologist....

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #11: Epidemiology and Risk Factors for Type 1 Diabetes Mellitus Part 5 of 5

In industrialized countries, 20–40% of T1DM patients younger than 20 years present with diabetic ketoacidosis. After adjusting for age, gender, ethnicity, diabetes type, and family history of diabetes, diabetic ketoacidosis at diagnosis was associated with lower family income, less desirable health insurance coverage, and lower parental education. Younger children present with more severe symptoms at diagnosis, because children younger than 7 years old have lost on average 80% of the islets, compared to 60% in those 7–14 years old and 40% in those older than 14 years.

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