January 12, 2016 : DCMS #275

DISASTERS AVERTED — Near Miss Case Studies

 Look at Whole Picture Before Complimenting Patient’s Weight Loss

HOMERUN SLIDES — Great Clinical Presentation Highlights

Diabetes for Cardiologists Part 5

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #1: Classification of Diabetes Mellitus and Other Categories of Glucose Intolerance Part 6 of 6

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dr. Don Fetterolf, Part 2: Treatment of Diabetic Foot Ulcers

MOST POPULAR ARTICLES OF THE MONTH

#1 Antioxidants May Help Reduce Diabetes Risk
#2 Liraglutide Success Shown Dependent on Early Weight Loss
#3 Diabetes Linked to Increased Risk of Tooth Loss

It has been a few years since Dr. Steven Nissan shook the diabetes world apart with his scathing review of the TZDs, pioglitazone and rosiglitizone. Many professionals blame him for the demise of rosiglitizone and the almost-death of pioglitazone, because of his comments on heart problems caused by the class ( https://www.diabetesincontrol.com/letter-from-the-editor-705-avandia-and-fda-approvals/ ). In addition his allegations caused the FDA to require much more cardiovascular testing on all new diabetes medications, pushing their approvals further behind. 2 years after all that clamor, the FDA basically told us that “oops” we were wrong about the TZDs, and the heart problems that supposedly came along with the whole class.

In fact, the newer data points to the cardio-protective value of pioglitazone. This week in our homerun slides specifically designed for Cardiologists, we discuss the use of pioglitazone for diabetes and good heart health.

Your partner in diabetes care,
Dave Joffe
Editor-in-chief

Some think you can’t be too rich or too thin. A stylish female, type 2 diabetes, 46 years of age came into the office (a weight loss clinic) for a follow up. Everyone was telling her how great she looked. She said she was feeling great and excited because she could fit into clothes she couldn’t fit in the past few years. She lost 9 pounds in three months. She had not been self monitoring her glucose. She was thrilled, but her doctor wasn’t so thrilled, at least not yet. He was concerned her glucose was elevated.

In this week’s Homerun Slides, the cardiovascular benefits of pioglitazone.

Impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG) are categorized as stages in the natural history of disordered carbohydrate metabolism. They occur in all individuals as they progress from normal to diabetes, but since the transition through these states is rapid in type 1 diabetes, they are rarely identified in such individuals. Therefore, nearly all of the literature dealing with IGT and IFG is concerned with issues relating to type 2 diabetes, such as risk of developing type 2 diabetes and CVD.

In part two of this discussion, hosted by Diabetes in Control Publisher Steve Freed, Dr. Fetterolf continues his explanation of the best treatments for diabetic foot ulcers and the additional challenges that patients with diabetes face.

Study shows high carotenoid serum concentration may prevent development of type 2.

Patients who responded to medication had greater improvement in cardiometabolic risk factors.

Study of 40-year trend focused on three ethnic groups prone to dental complications.