Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.
Letter from the Editor
The first line therapy for type 2 diabetes has long been metformin, and nowadays we are using it for patents who have prediabetes; it is also used “unofficially” by a lot of Weight Loss clinics. A lot of patients who are on metformin progress to insulin, and for many years the common practice was to stop the metformin when the patent started insulin. This never made a lot of sense to me, and when I worked in practice with some local endocrinologists we would always restart the patient on metformin as soon as we got the referral.
In the primary care office it was different and I spent many an hour convincing the prescriber to restart metformin on their insulin patients, and most every time the patient showed either an improvement in glucose levels or a lowering of insulin dose.
When it came to working with type 1’s it was a harder sell, as the common theory has been that metformin would not be of much help, but every time we added it to a type 1’s regimen we got improvement.
This week we have a large retrospective study that looks at how the use of metformin affected patients’ A1c, BMI and and insulin dose.
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We can make a difference!
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Dave Joffe
Editor-in-chief
This Week's Survey
When was the last time you rode a bike? Follow the link to see how you compare to your colleagues!
New Product: Lucentis Approved to Treat All Forms of Diabetic Retinopathy
Genentech’s Lucentis® (ranibizumab injection) 0.3 mg is now approved for the monthly treatment of all forms of diabetic retinopathy. Diabetic retinopathy is the most common cause of vision loss in people with diabetes and the leading cause of blindness among adults aged 20 to 74. Lucentis is the first and only medicine FDA-approved to treat all forms of diabetic retinopathy. The FDA granted Lucentis Priority Review based on an analysis of the NIH-funded Diabetic Retinopathy Clinical Research Network’s (DRCR.net) Protocol S study, which compared Lucentis treatment to panretinal laser treatment in diabetic retinopathy patients both with and without diabetic macular edema (DME), a complication of diabetic retinopathy that causes swelling in the back of the eye. Priority Review Designation is granted to medicines that the FDA has determined to have the potential to provide significant improvements in the safety and effectiveness of the treatment of a serious disease. In February 2015, Lucentis received FDA approval for the treatment of diabetic retinopathy in people with DME based on data from the pivotal RIDE and RISE Phase III clinical trials. In the analysis that supported today’s approval, patients both with and without DME in the Lucentis group experienced improvements in the severity of their retinopathy. Diabetic retinopathy affects nearly 7.7 million people in the U.S. This is the second FDA approval for Lucentis this year. In January, Genentech announced the approval of Lucentis for myopic choroidal neovascularization (mCNV), the first FDA-approved medicine to treat patients with mCNV in the U.S.
Test Your Knowledge
When diagnosing suspected nonalcoholic fatty liver disease (NAFLD), hepatic steatosis and inflammation with hepatocellular injury is an indication of which one of the following?
A. Nonalcoholic fatty liver (NAFL)
B. Nonalcoholic steatohepatitis (NASH)
C. Both of the above
D. None of the above
Follow the link to see the correct answer!
When it comes to antidiabetic therapies, professionals should be aware of safety concerns with concentrated insulin formulations, metformin and renal function, and SGLT-2 inhibitors and DKA. See the breakdown of these safety issues by Tom Palma, RPh, MS, BCPS, and Greg Wiggers, PharmD, PhD, plus exclusive commentary by DIC Advisory Board member Dr. George Bakris.
Could diabetes cause increased rates of dementia?
This study is the first retrospective, long-term analysis of metformin as adjuvant therapy to insulin in patients with T1DM.
What should you add to prevent a loss of limb?
This sweet treat may be future aid in diabetes treatment.
Medication showed significant reduction in risk for cardiovascular death, hospitalization for worsening heart failure.
Study finds connection between duration of therapy in senior patients and development of neurodegenerative disease.
Quote of the Week!
“Don’t wait until you’re in a crisis to come up with a crisis plan.”
…Phil McGraw
Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletter:
Priscilla Rettman, Philadelphia College of Osteopathic Medicine – GA Campus
Mark T. Lawrence, University of Colorado-Denver, School of Pharmacy NTPD
Your Friends in Diabetes Care
Steve and Dave
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