March 8, 2016 : DCMS #283

DISASTERS AVERTED — Near Miss Case Studies

Lactose vs. Lactulose

HOMERUN SLIDES — Great Clinical Presentation Highlights

Diabetes and Periodontitis Part 2

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #14: Epidemiology and Geography of Type 2 Diabetes Mellitus Part 3 of 5

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

 The Challenge of Managing Diabetes

MOST POPULAR ARTICLES OF THE MONTH

#1 Don’t Look, Don’t Know
#2 Diabetes and Periodontitis Part 1
#3 The Importance of Diabetes Self-Management Education

Over the past 30 years that I have been a pharmacist, we have had many sound-alike drugs. Many of you remember when Losec became Prilosec because of the confusion with Lasix. Often we don’t even see these problems unless someone has a bad event. This week our disaster avoided looks at what happens when a patient confuses a medicine with a food. The results could have been very severe.

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

I recently got a call at my office from a home healthcare nurse who was visiting one of my patients who was suffering from cirrhosis of the liver and experiencing high ammonia levels.

The patient was on basal insulin with mealtime rapid insulin and had been fairly well controlled. Over the past 2 weeks the patient had been experiencing low glucose levels before lunch and bedtime.

In this week’s Homerun Slides, the progression of periodontal disease and important factors to consider when assessing the periodontal disease status of patients with diabetes.

The proportion with previously undiagnosed diabetes varies with age. It seems to be highest at 30–39 years of age (70–80%), and lowest in the elderly (around 40%). The only exception was seen in European women where the proportion of undiagnosed diabetic cases was around 40–45% in all age groups.

Dr. Andy Rhinehart gives his perspective on the new insulins and the difficulty of managing diabetes for the patient as well as the healthcare provider.

Woman, 55 years of age, type 2 diabetes for 15 years. When first diagnosed, did all she could to learn everything about managing her diabetes. She even went to two complete diabetes education courses. The second she paid for on her own. In time, she started checking less, ate more and more unfriendly diabetes foods, and due to a chronic ankle problem, became more and more inactive. After losing her insurance, she then stopped taking her medications and checking her glucose, until she noticed bloody drainage on her clothes from rashes several places on her body.

In this week’s Homerun Slides, understanding the importance of oral health and alternatives to surgical options for treatment.

In part 4 of this Exclusive Interview, DIC publisher Steve Freed asks Dr. Andy Rhinehart, “How would you improve the care of a patient going to a family practitioner with type 2 diabetes?”