January 10, 2017 : DCMS #327

DISASTERS AVERTED — Near Miss Case Studies

How to Best Add or Adjust Medications

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Altamash Shaikh, Part 1, Diabetes in India

HOMERUN SLIDES — Great Clinical Presentation Highlights

EMPA-REG Outcome Trial, Part 4

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #57: Mechanisms of Insulin Signal Transduction Part 1 of 8

MOST POPULAR ARTICLES OF THE MONTH

#1 New ADA 2017 Standards of Medical Care in Diabetes
#2 Preventing CV Death in Patients With Diabetes
#3 Watch Out. It’s That Time of Year Again.

Five or six years ago, the widespread advertising of $4 dollar drug programs was in the wheelhouse of every pharmacy, and there were hundreds of drugs on the list. Since then the list has gotten much shorter and the number of pharmacies advertising them has decreased. Part of the reason for this decrease has been shortages of raw materials to produce these medications. One of the reasons this can occur is the increase of use in other countries. As larger countries like India or China have increases in diseases like diabetes and hypertension, they are adding pressures to the world medication supply. This week, we have an exclusive interview with Dr. Altamash Shaikh as he explains the current state of diabetes in India and the needs required to help this population to manage this condition.

Dave Joffe

Editor-in-chief

Man, 51 years of age, type 1 diabetes for 32 years. Patient also has history of Class II obesity, CVA, MI and insulin resistance. Patient referred to Obesity Center for weight loss. A1c was 8.2%. Plan was to start Symlin. Symlin was added at 30mcg daily before dinner. I recommended he get a CGM. He did.

Dr. Altamash Shaikh talks with Diabetes in Control Associate Medical Editor Joy Pape at the 2016 AACE Meeting. In part 1 of this Exclusive Interview, Dr. Shaikh explains the current state of diabetes in India and the needs required to help this population to manage this condition.

In this week’s Homerun Slides, the vital stats of patients on the placebo and empagliflozin 10- and 25-gram study.

Fuel homeostasis: The peptide hormone insulin is secreted from pancreatic beta cells, and exerts a broad spectrum of anabolic effects in multiple tissues. In response to a meal, insulin stimulates uptake and storage of carbohydrate, fat, and amino acids, while, at the same time, antagonizing the catabolism of these fuel reserves.

Psychological health, access to care, expanded and personalized treatment options and the tracking of hypoglycemia emphasized.

What do we need to tell our patients about preventing the risk for death?

Yes, it’s that time of year again when your phone/email/computer is busy with patients wanting appointments and making commitments to make their New Year’s Resolutions.

Often at this time of the year, my patients come in wanting to change just about everything about what they eat, when they eat, how much they eat, and the same for being physically active. So many of these patients have told me they have tried and tried and tried and failed in the past, but now it’s the New Year and it’s going to be different.