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Yearly Archives: 2016

Question #844

Test Your Knowledge

Which of the following is the correct diagnostic cut-point for diabetes? 1) A1C greater than or equal to 7% 2) Fasting plasma glucose (FPG) greater than or equal to 130 mg/dL 3) 2-hour plasma glucose greater than or equal to 200 mg/dL during an oral glucose tolerance test 4) Random plasma glucose greater than or equal to 300mg/dL in a patient with classics symptoms of hyperglycemia or hyperglycemic crisis Did you get it right? Follow the link to find out!

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July 26, 2016

There are various hormones, neurotransmitters, nucleotides, and fatty acids in the pancreas that affect insulin production and secretion. Sorting all these factors out, and how we might possibly affect glucose control by mimicking  some of these compounds, has opened up new avenues of treatment. GLP-1 agonists are just one example. This week in our …

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Sometimes it Takes a Human

63-year-old male, moderate cognitive impairment and lives alone. Patient lost a significant amount of weight, frequent symptomatic hypoglycemia, including light-headedness and dizziness, requiring lowering and stopping some of his glucose lowering medications. GLP-1 was stopped and his glucose levels were in normal range. We were very clear that he should not resume his GLP-1 until we saw him again.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #34: Beta-Cell biology of insulin secretion Part 4 of 5

Gs-protein-coupled receptor: In pancreatic beta cells, various hormones, neurotransmitters, nucleotides, and fatty acids including GLP-1, glucose-dependent insulinotropic polypeptide (GIP), vasoactive intestinal polypeptide (VIP), pituitary adenylate cyclase-activating polypeptide (PACAP), adrenaline, ATP/ADP, lysophosphatidylcholine (LPC), and oleoylethanolamide (OEA) activate their specific receptors. These receptors when coupled with Gs-protein activate adenylate cyclase and increase cAMP production. These cAMP-increasing ligands potentiate both the 1st phase and 2nd phase of GIIS.

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July 23, 2016

For many years, we have used finger sticks as the standard for diagnosis and management of diabetes. I can remember inviting patients to come to the pharmacy for a “diabetes day” where we offered free testing, and we would often find patients with elevated glucose levels. We would also spend …

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