March 25, 2017 : Issue #878

• “Normal” Urine Albumin to Creatinine Ratios Can Still Predict CV Risk
• Use of Liraglutide in Obese Patients May Reduce Risk for Type 2 Diabetes
• Weight-Loss Surgery Leads to Diabetes Remission
• Serum Metabolites Affect Kidney in Type 1 Diabetes
• Role of Genomic Variance to Belly Fat in Diabetes
• Use of Dietary Sugars or Glucose Tablets in Correcting Hypoglycemia

Most of the time when we speak about patients who are not diagnosed with diabetes and who develop complications, we are usually referring to vision changes or things like neuropathy. However, it now appears that there are a good number of these undiagnosed who die from ketoacidosis. This week, our intern took a curious look at American Journal of Forensic Medicine and found that almost one third of the the residents of Maryland who died from ketoacidosis did not have any inkling that they had diabetes, and they were younger than researchers anticipated. Check out this week’s DID YOU KNOW to learn more.

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We can make a difference!

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Dave Joffe

Editor-in-chief

Should physicians be able to help patients end their lives? Follow the link to share your opinion and see what your colleagues say.

By popular demand: updated Insulin chart with all the new insulins, showing the onset, peak and duration of action. Now also includes Walmart’s ReliOn brand.

The diabetes drug empagliflozin reduces all of the following CV risk factors except:
a. Blood pressure
b. Visceral adiposity
c. Low-density lipoprotein cholesterol
d. Triglycerides
e. Atrial stiffness

Follow the link to see if you got it right!

Researchers reported in the September issue of the American Journal of Forensic Medicine and Pathology that almost a third of Maryland residents who died of diabetic ketoacidosis over a six-year period had no known history of diabetes. Researchers said those who died probably had type 1 diabetes. The results underscore the importance of having regular physical examinations that include blood glucose measurement. People who don’t know they have type 1 diabetes may account for a surprising number of deaths from one complication of the condition. While the researchers weren’t able to definitively tell whether those who died had type 1 or type 2 diabetes, their high blood sugar levels suggest they probably had type 1. The finding highlights the need for regular physicals that include checking blood sugar levels, especially if warning signs of diabetes are present, the researchers said. In the study, they looked at 20,406 autopsies and found 107 people who had died from diabetic ketoacidosis, although only 92 had data available for further review.  Out of the 92 cases, they found that 60 people were previously diagnosed with diabetes, while 32 were not.  Nearly half of those who died with no history of diabetes were in their 40s. The researchers also found that 84 percent of these cases were men, and 53 percent were African-American. — The study was published in the September 2016 issue of the American Journal of Forensic Medicine and Pathology.

New evidence questions the idea of what is normal.

A new finding from the SCALE trial.

Gastric bypass surgery may treat type 2 diabetes in selected patients.

Changes in serum metabolomic profile affect eGFR in patients with type 1 diabetes.

Genetic predisposition to a higher waist-to-hip ratio may lead to diabetes.

Proponents may suggest an advantage of one over the other, but the data is not so clear.

Quote of the Week!

“Never be limited by other people’s limited imaginations.”


…Dr. Mae Jemison

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletter:

Mark T. Lawrence, University of Colorado-Denver, School of Pharmacy NTP

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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Ewing, NJ, 08628
USA
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