In this week's Homerun Slides, insulin initiation and a comparison of pharmacokinetic and pharmacodynamic insulins.

Cellular mechanisms of insulin resistance: The cellular events via which insulin initiates its stimulatory effect on glucose metabolism start with binding of the hormone to specific receptors that are present on the cell surface of all insulin target tissues. After insulin has bound to and activated its receptor, “second messengers” are generated and these second messengers activate a cascade of phosphorylation-dephosphorylation reactions that result in stimulation of intracellular glucose metabolism. The first step in glucose utilization involves activation of the glucose transport system, leading to glucose influx into insulin target tissues, primarily muscle. The free glucose, which has entered the cell, subsequently is metabolized by a series of enzymatic steps that are under the control of insulin. Of these, the most important are glucose phosphorylation (catalyzed by hexokinase), glycogen synthase (which controls glycogen synthesis), and phosphofructokinase (PFK) and PDH (which regulate glycolysis and glucose oxidation, respectively).

In this Exclusive Interview transcript, Kathleen Wyne talks with Diabetes in Control Medical Editor Joy Pape during the AACE 2018 convention in Boston, MA about adult onset type 1 diabetes and its misdiagnosis, and how to determine whether a patient has type 1 or type 2 diabetes.

In this Exclusive Interview, Kathleen Wyne talks with Diabetes in Control Medical Editor Joy Pape during the AACE 2018 convention in Boston, MA about the importance of understanding that adults can be diagnosed with type 1 diabetes and the commonality of the misdiagnosis of the condition.

First systemic treatment for patients who experience tumor-related symptoms such as hypertension

Herbal, chiropractic, massage, acupuncture, yoga most commonly used individual therapies

In part 1 of this Exclusive Interview, Kathleen Wyne talks with Diabetes in Control Medical Editor Joy Pape during the AACE 2018 convention in Boston, MA about the importance of understanding diabetes diagnosis — and misdiagnosis — in adults.

In part 2 of this Exclusive Interview, Kathleen Wyne talks with Diabetes in Control Medical Editor Joy Pape during the AACE 2018 convention in Boston, MA about proving type 1 in an adult who was previously misdiagnosed.

In part 3 of this Exclusive Interview, Kathleen Wyne talks with Diabetes in Control Medical Editor Joy Pape during the AACE 2018 convention in Boston, MA about the insufficiency of DKA as a method of diagnosing diabetes.

In part 4 of this Exclusive Interview, Kathleen Wyne talks with Diabetes in Control Medical Editor Joy Pape during the AACE 2018 convention in Boston, MA about the irrelevance of age when diagnosing diabetes and the protocol when screening for cardiovascular complications.