February 4, 2017 : Issue #871

• Caution: NSAIDs with SGLT-2 Inhibitors May Cause Renal Injuries
• Using Insulin Increases Stroke Risk in A-Fib
• The Disease That May Be a Leading Cause of Death
• Ertugliflozin Monotherapy in Patients with Type 2 Inadequately Controlled
• Lowering the Risk of Diabetes By Just Sitting Less
• Physical Activity Is Only One Part of the Equation
  • by Featured Writer Sheri Colberg, Ph.D.

When we were at the recent CES show in Las Vegas, the health and fitness categories had their own hall in the convention center. This is quite a change from 5 yeas ago when you only had one health related exhibitor. One of the other fast growing areas is combining work with physical activity, and there were multiple companies with desks with built in treadmills, and desks with attached stationary cycles. Stand-up adjustable desks were all over the exhibit hall, but not located near any of the fitness gear. That may have to change next year, as a new article just published in BMJ Open — a peer reviewed journal — showed that we may be able to lower diabetes by encouraging our patients to stand up while they work. Item #5 maps out why and how you can help lower the risk of diabetes by standing while you work.
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We can make a difference!

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Dave Joffe, Editor-in-chief

For a newly diagnosed type 2 patient with an elevated A1c of 7-8%, would you consider an SGLT-2 drug as a second treatment option added to metformin if they are not at goal on metformin? Follow the link to share your opinion and see what your colleagues think!

Lilly announces new program, in partnership with Express Scripts, to provide up to 51% off Lilly Insulin through Blink Health. The service is vulnerable patient populations such as people with diabetes, and those with no insurance or high out-of-pocket drug expenses. Anyone with a prescription for Lilly insulin products can receive the discounts. The discounts available through Blink Health exist separate from existing insurance plans. So anybody can “buy direct” through Blink Health – even if they have insurance – but it will be up to each insurance company to decide whether Blink Health purchases will count towards an individual’s deductible. Blink Health

Hypoglycemia is a potential side effect of which of the following classes of drugs:
1) Insulins
2) Sulfonylureas
3) Meglitinides
4) Amylin mimetics
5) All of the above

Follow the link to see the right answer!

In Chinese adults, diabetes was significantly associated with an increased risk for mortality from a range of cardiovascular and non-cardiovascular disease, study data show.  They evaluated data from a 7-year nationwide prospective study of 512,869 Chinese adults (mean age, 51.5 years; 5.9% with diabetes) recruited between June 2004 and July 2008. Follow-up was conducted until January 2014. According to researchers, this large prospective study of adults from rural and urban areas in China showed that diabetes was associated with significantly increased mortality from a wide range of diseases, with the greatest proportional excess mortality from diabetic ketoacidosis or coma and chronic kidney disease, followed by ischemic heart disease, stroke, other vascular, chronic liver disease, infection, certain cancers (mainly liver, pancreatic, female breast, and endometrial cancers), and external causes. Even though the prevalence of diabetes was higher in urban areas, diabetes was associated with greater excess mortality in rural areas.

Journal of the American Medical Association: Source Reference: Bragg F, et al “Association between diabetes and cause-specific mortality in rural and urban areas of China” JAMA 2017; DOI: 10.1001/jama.2016.19627.

New research finds issue in the setting of dehydration and/or during use of nonsteroidal anti-inflammatory agents (NSAIDs) or radiocontrast studies.

Investigation supports that early diabetes has lower thromboembolic risk than later.

Survey estimates that diabetes accounts for many more deaths in the United States than are being reported on death certificates — and that diabetes is actually the third leading cause of death.

Phase-3 study to evaluate efficacy and safety of ertugliflozin monotherapy.

A new study suggests that people who spend time walking or even just standing instead of sitting may be at lower risk of type 2 diabetes.

As an exercise physiologist, I first and foremost focus on the physical activity part for management of blood glucose levels, often stating that being active will increase insulin action, lower blood glucose levels, and make diabetes management easier. In reality, not all of those benefits are fully evident in many cases. In fact, they usually cannot be counted on unless you take into account myriad other factors that can have an equally—if not more—dramatic effect on blood glucose management.

Quote of the Week!

“Just don’t give up what you’re trying to do. Where there is love and inspiration, I don’t think you can go wrong.”

…Ella Fitzgerald

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