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Monthly Archives: March 2017

March 14, 2017

I recently had a conversation with one of my riding buddies about his A1c. His doctor had recommended he go on metformin because his A1c was 5.9. This guy sometimes rides 700 miles in a week and is thin as a rail. Our conversation got a response from three other …

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When Changing to Combo Pill, Know the Dosages You are Changing

Woman, 62 years of age, musician, travels often, type 2 diabetes, obesity, hyperlipidemia, fatty liver. Was traveling for two months straight on the road. Late nights/parties and a lot of drinking. Admitted not having taken her GLP-1 or really following any meal or healthy life plan/schedule she was following before leaving. Since last office visit 3 months ago, weight up 10 pounds, fasting glucose 170 in office.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #66: Regulation of Glucose Metabolism in Liver Part 2 of 11

Hepatic glucose production: Typical lean humans spend more than half of their lives in the post-absorptive state, with less than 5 g of glucose circulating in their blood to support life. Many tissues rely on glucose as their primary fuel source. Notable examples are brain, which has limited access to fatty acids, and erythrocytes which do not possess mitochondria and, therefore, rely on glycolysis to meet energy requirements. Even during rest the body uses roughly 8 g of glucose per hour, and during exercise this rate can increase more than twofold. The body would deplete circulating glucose in less than 30 min, resulting in severe hypoglycemia, loss of neurologic function and death, if not for a constant endogenous supply of glucose.

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March 11, 2017

For the first time in many years, the ADA has updated their guidelines on retinopathy. These new guidelines take into account the improvements that have been made in diagnosis and both medical and physical treatments. Most of our colleagues at other medical news outlets either paraphrased the guidelines or printed …

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2017 ADA Position Statement on Diabetic Retinopathy

This represents the first such update by the American Diabetes Association since 2002, and is notable for inclusion of the latest evidence and recommendations with respect to appropriate eye examination intervals, referral criteria, prevention of incidence and progression of diabetic retinopathy (DR), and treatment strategies.

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