Home / 2016 (page 122)

Yearly Archives: 2016

Reclassifying Diabetes: is it Time for an Expanded Definition?

For those healthcare providers who treat diabetes with any kind of regularity, it has become increasingly obvious that several of our patients fall outside the current diabetes classification system. With individualization of patient care being the new focus, it can be challenging to accomplish this, when certain diabetic individuals don’t “conform” to the current definitions.

Read More »

Artificial Pancreas Recommendations

The FDA-approved artificial pancreas will probably be available the first quarter of 2017 from Medtronic. Will you recommend it now or will you wait for at least 1-2 years? Follow the link to share your response!

Read More »

Question 855

Test Your Knowledge

Please select the drug class that best fits the description. This oral drug class slows the intestinal digestion and absorption of carbohydrates: 1. Sulfonylureas 2. DPP-4 Inhibitors 3. Alpha-glucosidase inhibitors 4. Bile Acid sequestrates Did you get it right? Follow the link to find out!

Read More »

Oct. 11, 2016

“You can’t cure me, ’cause there ain’t nothing wrong with me!!” If I only had a dollar for every time one of my patients told me this. What makes these ridiculous statements even harder to believe is that many patients will do everything properly to take care of themselves, and …

Read More »

Denial: Numbers Don’t Lie

Woman, 64 years of age. History of Class II Obesity and hyperlipidemia. While she had obesity, her glucose levels were elevated. A1C 8.2%. She followed a lower carb meal plan, was active, took metformin and a GLP-1, a statin and an ACE-I. She lost 22% total body weight. A1C then remained in the 6-6.5% range for 3 years on this treatment plan. Over the past 8 months, due to insurance and her statement of denial that she ever really had diabetes, she stopped taking her glucose-lowering medication, statin, and ACE-I, wasn’t as strict with meal plan or activity, and stopped checking her glucose, but did not gain back her weight.

Read More »

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #45: Neuropeptides and Islet Hormone Secretion Part 4 of 5

Sympathetic effects and mediation: Sympathetic nerves inhibit insulin and stimulate glucagon secretion. Their activation may help mediate stress-induced changes in islet hormone secretion including the glucagon counterregulatory response to hypoglycemia.These effects may be mediated by the combination of the classical neurotransmitter noradrenaline and the sympathetic neuropeptides (galanin and NPY). All three neurotransmitters can inhibit insulin and stimulate glucagon secretion, thus mimicking the effects of sympathetic activation on islet hormone secretion. In addition, galanin and NPY meet several other of the criteria needed to be classified as a physiologic neurotransmitter.

Read More »