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Monthly Archives: April 2016

April 23, 2016

Test Your Knowledge

Mr. Huang achieves good glycemic control with his lifestyle modifications, metformin and linaglipitin, and returns every 6 months for follow-up visits. Three years after initiating this treatment plan, he returns to your clinic for his 6-month check-up. When asked how his diabetes management is going at home, he shares that recently he has been “unable to really get out and get as much exercise as he know he should due to his creaky, old knees acting up.” His current office A1C is 8.8%. You discuss with him what the next management steps may be to achieve his individualized glycemic goal. What would your next medical management step be? Select one answer: A. Add a rapid-acting insulin analogue B. Add a long-acting insulin analogue C. Add a GLP-1 agonist D. Add a sulfonylurea Are you right? Follow the link to find out!

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Many of you know that although Metformin was first introduced in Europe in 1958, it was actually the second drug in the biguanide class. The first was Phenformin, which was introduced in the U.S. at about the same time. In 1975 Phenformin was withdrawn from the U.S. market due to …

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Last week I had my physical. When they checked my blood pressure, it was 141/81 and my doctor was a little concerned that it was elevated. He asked me if it was like this most of the time and I told him it was not. I asked him to check …

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Inpatient Teaching Should Include Outpatient (Real Life) Education and Supplies

One day a 31-year-old woman who had recently been hospitalized and subsequently diagnosed with type 1 diabetes came into our diabetes clinic for education. She had been discharged from the hospital less than a week prior to coming to our clinic. She was frustrated when she arrived, as her blood sugars had become increasingly elevated after leaving the hospital. She had called her primary care physician and he instructed her to increase her dose of long-acting insulin. Still, her blood sugars had not improved.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #20: Development and Maintenance of the Islet Beta Cell Part 4 of 4

For many years it was speculated that beta cells, much like neurons, were postmitotic and that their turnover in the mammal was minimal or zero. Over the last two decades, studies in mice have suggested a more dynamic picture, wherein beta-cell mass can change in response to physiologic states such as growth, pregnancy, and obesity.

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