Multiple testings still recommended for certain groups.

At what A1c do you feel comfortable using triple therapy for a patient with type 2 and excessive weight? 8%, 9%, 10%, or 11%? Follow the link to respond.

Mr. Huang is a 61-year-old Asian American businessman who comes in to see you for a follow-up appointment. He was diagnosed with type 2 diabetes four years ago and has a long-standing history (15 years) of hypertension and hypercholesterolemia, which are currently well-controlled. Current medications are metformin (1500 mg/day), lisinopril, and simvastatin. He has excess weight (BMI 29 kg/m2) but feels he has a healthy diet and gets out for a 25-30 minute walk 3 or 4 times per week. He feels great, but over the last nine months or so, he has noticed that his home average glucose levels are in the 180-198 mg/dL range. At today’s visit, his A1C is 8.3%. Based on Mr. Huang’s individual glycemic target of A1C<7%, you would like to add another antihyperglycemic. You choose linagliptin over glimepiride. What is the best reason for your choice?

A. Greater weight loss benefits
B. More effective at lowering blood glucose levels
C. Lower cost of treatment

Follow the link for the answer.

Metformin alone or after insulin no help in youth with new diabetes, impaired glucose tolerance

Lower risk of incident obesity for offspring whose moms have healthy BMI, engage in physical activity

No reduced risk of hypoglycemia-linked ER visits, admissions for basal insulin analog vs. NPH insulin

Changes will describe hypoglycemic coma and clarify and identify mental health side effects

Not linked to incident acidosis overall, in those with eGFR levels of 30 to 44, 45 to 59 mL/min/1.73 m²

Circadian misalignment affects insulin sensitivity and insulin secretion in humans

There have been many studies that have been conducted meant to access the effect of alcohol consumption on diabetes - some suggesting that a moderate intake contributes to the risk for diabetes, and others suggesting moderate alcohol is a protective for type 2 diabetes.