August 30, 2016 : DCMS #308

DISASTERS AVERTED — Near Miss Case Studies

Out of Insulin, Too Early to Renew — What To Do?

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

 Dr. Stanley Schwartz Part 1, New Diabetes Classification

HOMERUN SLIDES — Great Clinical Presentation Highlights

Team-Based Approaches to Help Older Adults with T2 Achieve Individualized Glycemic Goals Part 1

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #39: Normal Beta-cell Function Part 4 of 6

MOST POPULAR ARTICLES OF THE MONTH

#1 Blood-Pressure Drug Could Be A Possible Type 1 Diabetes Cure
#2 Can a 100-Year-Old Vaccine Bring Us a Cure for Type 1?
#3 Probiotics for the Management of Diabetes

Three days ago I got a call from a patient who needed some insulin. The problem was, I had not seen the patient in 6 years — since I had first trained him on his insulin pump. Apparently they had gone out of town; he had prefilled cartridges with him and left them in a hotel refrigerator, and totally forgot to grab them when he left. He got home, and when he went to change his cartridges there were none to be had. Since it was a Sunday, there was no way we could get him samples, but I was able to get a coupon for a free vial from an educator friend and the problem was solved.

This kind of thing happens more often than you think, and this week, Laurie Klipfel, RN, MSN, BC-ANP, CDE, shares a similar experience, and what can be done to avoid the problem.

Dave Joffe

Editor-in-chief

It is not unusual for people to have difficulty keeping insulin from freezing or getting overheated. A patient, with type 1 diabetes for 17 years, had glucose that did not respond to his rapid-acting insulin as it usually does. He had two new vials in the refrigerator. He took a new vial out of his refrigerator earlier in the day, and started using it a few hours after he took it out. Had high post prandials that did not respond as usual to correcting. He had enough experience to wonder if perhaps something was wrong with his new insulin, so he thought he’d try another vial. He saw it was frozen. He had put the two vials at the back, where for many refrigerators it is colder. He thought back and wondered if the first vial looked any different, but remembered, he did not look closely at it.

In part 1 of this Exclusive Interview, Dr. Stanley Schwartz explains how the current understanding of diabetes surpasses the diabetes classifications determined long ago. He explains how understanding the inner workings of a specific patient can determine the best therapy for that patient, whether diabetes classifications change or stay the same.

In this week’s Homerun Slides, Dave Joffe, editor-in-chief of Diabetes in Control, presents strategies for helping type 2 patients to achieve their glycemic goals, starting with an outline of diabetes team members.

Beta-Cell response to hormones and the nervous system: As already mentioned insulin is the only hormone with a blood glucose lowering effect, while many other hormones (glucagon, cortisol, adrenaline) exert a hyperglycemic action. The changes in glucose levels elicited by these hormones obviously will be detected by the beta cell, which will respond by enhancing insulin secretion. Yet, all these hormones, as well as others and the nervous system exert a coordinated direct effect on the beta cell resulting in an integrated and sophisticated control network.

A common blood pressure drug is showing new promise to help treat and cure type 1 diabetes.

In part 1 of this exclusive interview, Dr. Faustman discusses her research and why an old tuberculosis vaccine may lead us to a cure for type 1.

Can probiotics improve A1c’s, plus much more?