July 23, 2016 : Issue #843

• The Influence of Diabetes Management on Kidney Function
• Death Rate and Blood Glucose Management
• HbA1c Testing Becoming a New Norm in Healthcare Setting
• HbA1c Changes Against Microvascular Complications in Type 1 Diabetes
• Exercising and Cardiovascular Risk
• How Will CGM’s Success Impact Conventional Glucose Monitors?
  • Guest Post by David Kliff, Diabetic Investor

For many years, we have used finger sticks as the standard for diagnosis and management of diabetes. I can remember inviting patients to come to the pharmacy for a “diabetes day” where we offered free testing, and we would often find patients with elevated glucose levels. We would also spend time getting patients to check their glucose 4-6 times a day to help them learn to manage their diabetes. This was often the hardest thing to do long term, and patients would have many more readings in their logbook than on their meter.

Thanks to technology, this is all changing. We now can use an A1c test to diagnose diabetes and Item #3 looks at unique places that this testing is being done. We also have the latest information on using CGM instead of finger sticks for managing diabetes based on the new FDA indications, and our good friend from Diabetic Investor shares his comments on how this new FDA guideline may change the whole monitoring business.

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We can make a difference!

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Dave Joffe, Editor-in-chief

Synjardy® (empagliflozin/metformin hydrochloride) to include treatment-naïve adults.

8-2 vote backs continuous glucose monitor to replace fingersticks.

Sanofi brings you a comprehensive, centralized educational resource designed for Nurse Practitioners and other medical professionals who care for patients with diabetes.  Wellness iNPractice Diabetes brings together educational and clinical resources to help keep you up to date on your overall knowledge of diabetes and to enhance patient engagement. Here you can find clinical practice resources and tools relevant to day-to-day diabetes care and self-management education and support for your patients.

Do you promote the use of metformin to help prevent cancer as well as to control blood sugars? Follow the link to share your opinion and see what your colleagues think!

In the fasting state, hyperglycemia is directly related to:

1. Increased hepatic glucose production
2. Defective insulin stimulation of target tissue glucose disposal
3. Decreased adipocyte lipolysis
4. Loss of pancreatic α-cell functionality

Did you get it right? Follow the link to find out!

People with impaired glucose tolerance (IGT) also have an increased risk of mortality, as well as a high risk of developing type 2 diabetes. In this follow-up analysis of 542 people in China who had taken part in a six-year lifestyle diabetes prevention trial, researchers looked at whether the excess mortality risk was due to an impaired glucose state or if it was the result of subsequent progression to type 2 diabetes. Analysis of 23 years of follow-up data indicates that much of the increased mortality risk could be explained by the development of type 2 diabetes, providing further support for the need for intervention and treatment at the prediabetes stage. https://dx.doi.org/10.2337/dc16-0429

Is extreme management of diabetes hurting or helping the kidneys?

Is extreme blood glucose control increasing or decreasing mortality rate in hospitalized patients?

HbA1c testing determines diabetes and prediabetes in patients who are not yet diagnosed

Does HbA1c variability predict retinopathy, nephropathy?

Is moderate exercising helping or hurting cardiovascular outcomes?

Guest Post by David Kliff, Diabetic Investor
The FDA approved Dexcom’s request for a non-adjunctive claim this week. It looks like a bad situation for conventional glucose monitors, and believe it or not is about to get worse. Here’s why.

Quote of the Week!

“He who has a why to live can bear almost any how.”

…Friedrich Nietzsche

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
810 Bear Tavern Road Suite 102
Ewing, NJ, 08628
USA
www.diabetesincontrol.com