January 14, 2017 : Issue #868

• Why Prediabetes?
• Obamacare: Repeal or Replace?
• ADA’s New Focus on Total Patient
• The Most Common Hassle For Type 1 Diabetes Patients
• The Future of Cardiovascular Research
• Dr. Pam R. Taub, A Cardiologist’s Experience with Diabetes Patients
  • View Video  |  Read Transcript

This past Thursday, Congress passed a resolution to begin the dismantling of the Affordable Care Act. If you remember, many of the candidates, including the president-elect, touted this as their first act if they won the election. Now that they have made the first move, you have to wonder if this is grandstanding on a campaign promise or if it is what the future holds.

As a medical professional who sees patients with chronic conditions, I know the difference that ACA has had on my patients’ care and what will happen if this affordable option disappears. Most times the value is lost in the politics and the histrionics that surrounded the program, and not enough attention is paid to what people really want. Our publisher, Steve Freed, reached out to the Center on Health Insurance Reforms and the Kaiser Family Foundation, to get the results of a study they did with both consumers and prescribers. The answers they got may surprise you.

Part of the success of ACA was the great uptake in preventative care appointments. This can be readily seen in Item #1 where we look at prediabetes as a disease.

Dave Joffe
Editor-in-chief

Now that we have a drug (SGLT-2) that can prevent the death of those with diabetes by 38%, do you see yourself informing your patients about this option or will you stay with the status quo?

1) inform patients
2) Stay the course

Follow the link to share your opinion!

DexCom, Inc. is pleased to announce the determination of a benefit category and coverage for CGM by Centers for Medicare & Medicaid Services. In order to be included in this category, the system must be defined as “therapeutic” CGM, meaning you can make treatment decisions using the device. Today, the Dexcom G5 Mobile is the only CGM system that falls within this classification.

A new report presents 10 quality and performance measures that are intended to help stakeholders–including health systems, legislative bodies, and nongovernmental organizations, as well as healthcare practitioners, patients, families and communities–in the effort to prevent sudden cardiac death (SCD). The joint report was published Dec. 19 in the Journal of the American College of Cardiology and Circulation: Cardiovascular Quality and Outcomes. In the U.S., approximately 356,500 out-of-hospital cardiac arrests occur each year. Many of the sudden deaths occurring in the U.S. may be prevented by implementing evidence-based and guideline-endorsed recommendations for primary or secondary prevention of SCD. The performance measure set is intended to assist clinicians and help them provide better care for their patients at risk of sudden cardiac arrest and thereby to improve care and outcomes.  — 10 Measures To Prevent Sudden Cardiac Death (pdf)

Renowned Physician, Educator and Researcher William T. Cefalu, MD to replace Robert E. Ratner, MD, who is now retired.

According to the Standards of Medical Care in Diabetes, which medication class places asymptomatic patients at increased risk of developing type 2 diabetes and is an additional indication for diabetes screening?

A. Atypical antipsychotics
B. Glucocorticoids
C. Both A and B
D. Neither A nor B

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

Adults with diabetes are 70% more likely to die from CVD than those without diabetes, according to the CDC.  But now we have a new drug that the FDA has approved for a new indication to prevent clinical cardiovascular disease. Empagliflozin (Jardiance) is now allowed to be used to reduce the risk of cardiovascular death in adult patients with type 2 diabetes (T2D) and cardiovascular disease (CVD). The agency based its decision on the results of a post-marketing study it required when it initially approved Jardiance in August 2014 as an adjunct to diet and exercise to improve glycemic control in adults with T2D. In a clinical trial of more than 7,000 patients with T2D and CVD, the use of Jardiance was found to reduce the risk of cardiovascular death compared with placebo when added to standard of care therapies for diabetes and atherosclerotic CVD. Additionally, Jardiance is not intended for patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. The drug is contraindicated in patients with a history of serious hypersensitivity reactions to Jardiance, severe renal impairment, end-stage renal disease, or dialysis. — FDA News Release Dec. 2016

Can we answer the question of how you can have a pre-disease that increases your risk of death? You either have it or you don’t!

Recent survey finds support for keeping parts of it intact, even those who want it repealed.

What does it mean when we say we need to focus on the total or whole patient?

Barrier means more work including monitoring more often and making more adjustments.

Trial shows mobile devices may be useful in future health studies.

Dr. Pam Taub talks with Diabetes in Control Publisher Steve Freed at the 2016 AACE Meeting about her experience as a cardiologist working with diabetes patients who are often coming to her for cardiology treatment and starting diabetes treatment as well.

In the transcript of this exclusive interview, Dr. Taub discusses her experience as a cardiologist, seeing patients with various cardiac diseases, about 75% of whom have diabetes.

Quote of the Week!

“Be faithful in small things because it is in them that your strength lies.”

…Mother Teresa

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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www.diabetesincontrol.com