Health expenditure greater for person with two diseases simultaneously than for the diseases separately

My wife is heading in to her first appointment with an endocrinologist. After 3 years of controlling her glucose with long acting insulin, a GLP-1 analog and an SGLT-2I, she had to go on meal time insulin. The use of meal time insulin forced her to check her glucose more …

New technologies have the potential to revolutionize diabetes care. But what are the advantages and disadvantages of insulin pumps, vs. daily injections? How widely will they be adopted, by patients with type 2 diabetes as well as type 1? What factors will make a difference for adoption – convenience, accuracy, costs? In November, we asked you to help us examine the future of insulin delivery and find the answers to these questions. Now we’re sharing all the results with you, so that you can see for yourself how your fellow members of the diabetes community plan on using CGMs, now and in the future.

By Sheri R. Colberg, PhD, FACSM
At each dawn of a new year, many people make resolutions to be more physically active—only to fail in changing their lifestyle habits in a sustained manner. Don’t be one of the many who start exercising only to stop again a few months later. Read more about why daily release of feel-good brain hormones is so important and why you should learn how to relax more as well.

Even though most diabetes drugs can help in managing blood sugar levels, they can also be detrimental to the heart.

Study findings warrant cautious consideration and discussions about risk vs benefit when considering therapy.

Study compares enhanced patient care experience with standard shared medical appointments to determine if a significant benefit will result.

Guest Post by David Kliff, Editor, Diabetic Investor
Although we haven’t gotten there just yet, it’s no longer a question of if type 2’s start using CGM, but when they do and how they use it. CGM is not like an insulin pump when it comes to having a finite market size. CGM is a valuable tool regardless of whether the patient uses insulin.

John S. is a 63-year-old Caucasian man with significant abdominal obesity, type 2 diabetes, hypertension, and dyslipidemia as well. On the basis of an exercise stress test, John was recently diagnosed with silent ischemia. John’s current medications include metformin, a DPP-4 inhibitor, an ACE inhibitor/HCTZ agent, a calcium channel blocker, a high-dose statin, and ezetimibe. John’s relevant physical exam and laboratory findings are as follows:

BMI 34.8 kg/m2
Blood pressure 140/86 mm Hg
HbA1C 7.2%
Total cholesterol 150 mg/dL
LDL-C 79 mg/dL
HDL-C 42 mg/dL
Triglycerides 145 mg/dL
non-HDL-C 118 mg/dL
eGFR 65 mL/min/1.73 m2
ACR 100 mg albumin/g creatinine

You explain John’s options for antihyperglycemic therapy. Which of the following answers most accurately describes the extraglycemic benefits of the different options?

A. The GLP-1 receptor agonists may improve endothelial function and reduce infarct size and the SGLT2 inhibitors are likely to improve arterial blood flow.
B. The DPP-4 inhibitors are not safe for people with cardiovascular disease, while the proven cardiovascular benefits of GLP-1 receptor agonists are consistent across the class.
C. DPP-4 inhibitors and SGLT2 inhibitors both reduce blood pressure, which accounts for their similar effects on heart failure.
D. The cardiovascular benefits of both the GLP-1 receptor agonists and SGLT2 inhibitors derive mainly from their effects on weight.

Follow the link for the answer.

Which insulin pump do you prefer for most of your patients? Medtronic, Tandem, or Omnipod? Follow the link to share your opinion.