April 16, 2016 : Issue #829

• FDA Warns of Increased Heart-Failure Risk With Two New Diabetes Drugs
• Prevalence of Diabetic Nephropathy In Pediatric Patients
• Prediabetes Patients Improve Fasting Glucose with Zinc
• Effect of Leisure-time Physical Activity on HbA1c in Type 2 Diabetes
• Prevalence of Diabetes in U.S. Adults from 1988-2012
• Reduction in Blood Glucose through SGLT-2 Therapy Does Not Prevent Diabetic Bone Disease
• Special Feature: Team Novo Nordisk’s Peron Helps Inspire Athletes with Diabetes

This past week I got to catch up with our good pal Phil Sutherland. Many of you know that Phil has worked hard to grab worldwide attention for athletes with diabetes. He is the founder of Team NovoNordisk, a Tour de France quality professional cycling team. All of the team members have type 1 diabetes, and they get no headstarts or early finishes when racing against the best cyclists in the world. The team just competed in the 293km (175 mile) Milan-San Remo 1 day classic. These riders had to not only finish the grueling course: they also had to manage their glucose levels for the entire ride, while competing with World Champion Peter Sagan and others.

Check out our special feature to see how they did.

And if thinking about racing brings out your competitive side, you can click here and take the A1C Challenge.

Announcements:

Diabetes Summit 2016

DIC Publisher Steve Freed will be attending the GTCbio 2016 Diabetes Summit, to be held April 25-27, 2016 in Boston, MA.  This unique event encompasses the drug discovery and partnering aspects of diabetes in two individual conferences that take place concurrently. Click here for more information.

dLifeTV.com: Sunday, April 10, 7PM ET

From dLife.com: “An Olympic legend shares his troubles with and inspiring triumphs over diabetes. Plus, a low carb Asian appetizer in the dLife kitchen, and a profile of MLB pro pitcher Brandon Morrow.” Sundays live online at dLifeTV.com at 7 PM ET, 6 PM CT, and 4 PM PT. Keep up on the latest dLife news at dLifeTV.com.

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We can make a difference!

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Dave Joffe, Editor-in-chief

Dexcom Inc. is recalling the Continuous Glucose Monitoring Systems because the audible alarm may not activate in the receiver piece when low or high glucose levels (hypoglycemia or hyperglycemia) are detected. Relying on this product for notification of low or high blood sugar could result in serious adverse consequences, including death as the auditory alarm may not sound and users might not be notified of low or high blood sugar. The FDA has identified this as a Class I recall, the most serious type of recall.  Click here for full details. 

For your patients with prediabetes (A1c of 5.7 to 6.4%), do you recommend they begin metformin even with providing them info on physical activity and nutrition?

Follow the link to express your opinion!

The FDA has developed a free, Continuing Education Course for healthcare professionals, FDA Overview of Biosimilar Products, to help them strengthen their knowledge and understanding of biosimilars and interchangeable products. Biosimilars and interchangeable products, for instance, are not generic products, and this education course will help healthcare professionals fully appreciate the distinction. Learn About Biosimilars

See this week’s fact.

Mr. Carlson is a 52-year-old Caucasian grocery store manager you saw last week for a new patient visit. His labs from that visit were significant for elevated random plasma glucose 166 mg/dL, A1C 7.4% and elevated lipids (TG=175 mg/dL, LDL 148 mg/dL, HDL 38 mg/dL, total cholesterol 221 mg/dL). He has returned to your clinic for a follow-up appointment. His physical exam is notable for central abdominal obesity (waist circumference 42”), left eyelid xanthelasma, BP 147/91, HR 72, RR 18, BMI 36 kg/m2, but otherwise normal. A repeat A1C test shows A1C 7.6%. Mr. Carlson smokes between 1 and 1.5 packs of cigarettes daily. After discussing the labs and your findings with Mr. Carlson, you begin collaborating on a management plan. You write prescriptions for metformin, a statin and ACE inhibitor. Mr. Carlson doesn’t think “taking medication will be too tough,” but expresses skepticism about your recommendations for a change in his diet, exercise and smoking programs because he has tried them, without success, in the past.

You are concerned about Mr. Carlson’s cigarette use because cigarette smoking has been shown to have multiple physiological impacts on health. Which one of the following statements regarding smoking and type 2 diabetes is true?

A. It equally affects all-cause mortality in individuals with and without diabetes.
B. In individuals with diabetes, it causes more rapid progression to micro- and macroalbuminuria.
C. It has not been linked to worsening glycemic control.
D. The use of bupropion is contraindicated in diabetes.

Think you’ve got the right answer? Follow the link to check!

Medicare unveiled a new initiative that would allow reimbursement for diabetes prevention programs to all seniors covered by the program.  Secretary of Health and Human Services Sylvia Mathews Burwell detailed the new plan to reimburse recognized providers of diabetes prevention programs to eligible beneficiaries. Medicare has always reimbursed providers to screen for diabetes and to treat those who have the disease, but there wasn’t a way for providers to be reimbursed to stop that progression altogether. There are nearly 86 million prediabetic adults in the U.S., and at least 22 million of them are over the age of 65. Progression of the condition can be properly controlled with interventions like those provided by Omada and the YMCA. The total saved per beneficiary was $2,650 over 15 months, and participants lost about 5% of their body weight, enough to help change their health trajectories and reduce their diabetic risk. Without intervention, nearly a third of prediabetic patients will progress to type 2 diabetes over the next three years, according to the ADA.  Medicare spent more than $15,700 per beneficiary with diabetes in 2014, but effective intervention strategies could decrease federal spending on diabetes treatment by $1.3 billion in the first decade. Department of Health and Human Services March 24, 2016

New alert issued for type 2 patients taking saxagliptin (Onglyza, AstraZeneca) and alogliptin (Nesina, Takeda).

Marked increase found at age 12.

Six-month regimen of 30 mg zinc sulfate once daily found effective compared with those on placebo, according to study.

Are some leisure-time activities more helpful than others in lowering blood glucose?

Overall prevalence of diabetes may have increased, but undiagnosed diabetes may be declining.

Team Novo Nordisk’s Italian sprinter, Andrea Peron, rode in the main breakaway at the 107th edition of Milan-San Remo for the second consecutive year. The 293-kilometer race is the longest one-day race in the world.

Take bone density, history of osteoporosis into consideration when prescribing.

Quote of the Week!

“It is in your moments of decision that your destiny is shaped.”

…Tony Robbins

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletter:

Devon Brooks, LECOM College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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