April 26, 2016 : DCMS #290

DISASTERS AVERTED — Near Miss Case Studies

One Bite at a Time

HOMERUN SLIDES — Great Clinical Presentation Highlights

Diagnosing Diabetes Mellitus in Adults: Type 1, LADA, Type 2

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Eran Bashan Part 1, An Overview of d-Nav

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #21: Pancreatic Morphology in Normal and Diabetic States,  Part 1 of 4

MOST POPULAR ARTICLES OF THE MONTH

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#3 What You Don’t Know About Statins and Exercise Can Hurt You

When patients ask me where insulin comes from, the automatic answer is the pancreas. I will often show them a drawing of where that is in the body. Most patients note how large the organ appears to be and wonder how they can be losing the ability to make and secrete insulin from such a large organ. They seem quite shocked when they find out that the area that produces the insulin, amylin, and glucagon is about the size of a quarter. Often they have no idea what the rest of pancreas is used for. Although there are some beta cells spread throughout the exocrine part of the pancreas, it is that small part of the organ that is responsible for maintaining glucose homeostasis. To understand how the exocrine and endocrine system actually work together, you will want to check out this week’s Clinical Gem from the International Textbook of Diabetes Mellitus, 4th Ed.

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

Woman, 42 years of age, class III obesity, type 2 diabetes diagnosed in the past year, binge eating disorder. Very motivated to change lifestyle when first diagnosed. She goes off and on her medication. When off, she binges. As an hcp, I wondered about the severe changes from totally “on” to totally “off.” Yes, this patient is receiving counseling, CBT.

In this week’s Homerun Slides, the failure of the current classification of diabetes and a comparison of the definition of each current diabetes type.

In part 1 of this Exclusive Interview, Eran Bashan explains d-Nav, an automated solution for insulin management that tailors the insulin regimen to the individual needs of the patient.

The pancreas is located in the upper abdominal cavity, in close proximity to both the duodenum and spleen. In humans, pancreatic weight ranges from 40–150 g. Embryonically, the pancreas develops from two separate buds of the primitive foregut, yielding duodenal (ventral) and splenic (dorsal) lobes.

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

25-40% of hypertension patients require only monotherapy to control BP, so choice of right single therapeutic agent is critical.

I recently received an email from a person with type 1 diabetes living in Denmark (Guido) whose physician believes in prescribing many medications to manage cholesterol and high blood pressure in anyone with diabetes, regardless of need. Guido has been taking a statin (Atorvastatin, brand name Lipitor), along with at least four others for blood pressure control. He used to take Simvastitin (Zocor), but a year prior had been changed to Atorvastatin (and his dose doubled). That’s when his problems with exercise began.