January 26, 2016 : DCMS #277

DISASTERS AVERTED — Near Miss Case Studies

 Think Out of the Box!

HOMERUN SLIDES — Great Clinical Presentation Highlights

Diabetes for Cardiologists Part 7

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #8: Epidemiology and Risk Factors for Type 1 Diabetes Mellitus Part 2 of 5

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

 Dr. Don Fetterolf, Part 4: Identifying and Treating 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 is very frustrating when we take our time to educate patients on the complications of diabetes and then they flat out ignore us. These patients usually don’t have symptoms that make them feel bad, and so they feel we are overreacting and don’t really listen or make changes. Usually this changes when they get the first couple of negative effects.

Their vision often changes, but that one doesn’t often get blamed on diabetes; however, pain and numbness in the feet usually does get their attention and diabetes often gets blamed for it. These patients are often ready to make changes, but want instant relief. When that doesn’t happen, they often fall back into their old habits. Unfortunately this can lead to the more serious problems of foot ulcers and wounds that often lead to amputation. This week, we finish up our video interview set with Dr. Don Fetterolf and his thoughts on new ways to treat these wounds and reduce amputation. If you have not watched any of these I encourage you to take the time to view all 4 parts.

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

A woman in her 60s, extremely insulin-sensitive with type 1 diabetes, came for a review of carb counting and blood sugar logs.  Pt had been running blood sugars above the target range. When asking pt why she thought her blood sugars were running high, she stated she was fearful of having low blood sugars….

In this week’s Homerun Slides, the natural history of type 2 diabetes, the eight core defects implicated in the pathogenesis of type 2 diabetes, and the effects of treatment.

Type 1A diabetes results from a chronic autoimmune destruction of the pancreatic beta cells, probably initiated by exposure of a genetically susceptible individual to some environmental agent(s). This preclinical period is marked by the presence of autoantibodies to pancreatic beta-cell antigens such as insulin, GAD65 (Glutamic Acid Decarboxylase), ICA512 (called also IA-2) or ZnT8 (Zinc Transporter 8), and precedes the onset of hyperglycemia by a few years.

In the final installment of this interview with Dr. Don Fetterolf, Diabetes in Control Publisher Steve Freed asks about recommendations for identifying and treating diabetic foot ulcers.

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.