Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.
Letter from the Editor
A lot of our readers get into diabetes care because of a personal or family association with the disease. I did just the opposite. When our publisher, Steve Freed, got me involved 20 years ago I had no connection to the disease, but as the years have gone by, I have been able to use my knowledge to help family members more than once. Just recently a close family member had their labs done and came back with a 435 mg/l glucose reading, and a subsequent A1c revealed a 13.1 level. The patient had been using hormone pellets and although her testosterone was at 245, this was within the normal range for the therapy. I believed this was the reason for the high glucose levels, but they could not be removed. I immediately called the prescriber to ask them to start her on metformin 500mg bid and 20 units of glargine. We titrated the glargine up to 40 units daily and got the glucose levels down to around 170mg/dl. We had a C-peptide test done and the levels were nondetectable. Five days later, we started the patient on Farxiga 10mg and a low carb diet. 4 months later, the patient is on 5 units of glargine, the Farxiga, and A1c is now 7.1. The pellets have been reinserted, and there has been no weight gain.
If you wonder how this could have happened, then I encourage you to look at Item 1, Item 2 and Item 5, and then decide if this makes sense.
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We can make a difference!
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Dave Joffe, Editor-in-chief
This Week's Survey
What do you recommend to your patients as the first choice to treat hypoglycemia?
1. Glucose tablets
2. Glucose gel or liquid
3. Juice, soda or milk
4. Honey or cake gel
5. Hard Candy (Smarties)
6. Other
Follow the link to share your opinion and see what your colleagues think!
Tool for Your Practice: No No Foods for a Low Carbohydrate Diet
The diet from Dr. Richard K. Bernstein for your patients who want to know what kind of foods can raise their blood sugars. Plus, how to start a low carbohydrate / high protein diet. Get the chart.
Test Your Knowledge
This class of drugs is typically reserved for individuals with type 1 diabetes or others receiving intensive insulin therapy. It inhibits glucagon secretion and slows gastric emptying:
1. Amylin mimetics
2. GLP-1 receptor agonists
3. DPP-4 inhibitors
4. SGLT-2 inhibitors
Did you get it right? Follow the link to find out!
Did You Know: Statins Plus Insulin Can Reduce Cancer Risks
A new study showed that type 2 diabetes patients who took insulin or insulin secretagogues and statins had a reduced risk of cancers of the brain, colon, liver, lung, pancreas and prostate, with a greater reduction seen among those who didn’t receive antihyperglycemic drugs. The researchers used a cohort of 1,847,051 patients with hospital stays during 2006 to 2007 and found the strongest effects for insulin use and pancreatic cancer, sulfonylureas or glitazones and skin cancer, and metformin and prostate cancer, corpus uteri and non-Hodgkin’s lymphoma. There is firm evidence of a relation between type 2 diabetes (T2DM) and increased risks of cancer at various sites, but it is still unclear how different antihyperglycemic therapies modify site-specific cancer risks. The aim of this study was to provide a complete characterization of all possible associations between individual T2DM therapies, statin use and site-specific cancers.
The use of statins offsets insulin-related cancer risks in patients with diabetes independently of sex and age. Overall, the data supports the hyperglycemia–cancer hypothesis. A reduction in endogenous or exogenous hyperinsulinaemia may be beneficial for cancer prevention. Therefore, insulin-sparing and insulin-sensitizing drugs should be the preferred treatment choices. — Published online Oct. 21 in the Journal of Internal Medicine.
There has been a controversy over the last 30 years as to which is the best diet to prevent diabetes.
High Protein vs. High Carbohydrate: Comments from Richard K. Bernstein MD
Cognitive decline in older adults with T2 may start to develop years before diagnosis, even in the prediabetes stages
Study also finds reduced heart rate variability (HRV) in overweight patients with newly diagnosed type 2 diabetes (T2D) and stable coronary artery disease (CAD).
Pair may improve glycemic control and allow for reduction in insulin dose without significantly increasing hypoglycemia.
Women who are diagnosed with PCOS are at increased risk for prediabetes.
Quote of the Week!
“Take care of your body. It’s the only place you have to live.”
…Jim Rohn
Your Friends in Diabetes Care
Steve and Dave
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