May 2, 2017 : DCMS #343

DISASTERS AVERTED — Near Miss Case Studies

Dealing with Diabetes Burnout

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Michael Hill Part 6, Monitoring Adolescents

HOMERUN SLIDES — Great Clinical Presentation Highlights

Insulin & Vascular Function Part 2

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #73: Regulation of Glucose Metabolism in Liver Part 9 of 11

MOST POPULAR ARTICLES OF THE MONTH

#1 A Major Shift in Diabetes Treatment Targets and Goals
#2 Sweetening with Stevia
#3 New ADA 2017 Standards of Medical Care in Diabetes

We all make the assumption that insulin resistance comes from eating too much glucose. However, for many patients, this resistance occurs because they release too much insulin. This can be environmentally related or it can be blamed on heredity. Regardless of the cause, this hyperinsulinemia can result in long-lasting effects on the cardiovascular system. This week, in part 2 of our Homerun Slides series we look at how they are related and what pathways the damage follows.

Dave Joffe

Editor-in-chief

23-year-old female, type 1 diabetes since 5 years of age. A1C elevated to 8.9% after usually having A1Cs in the 6-7 range. Came to see me at the end of our workday after wearing LibrePro (Blinded CGM) to go over her food/insulin/glucose/activity/etc. patterns. First thing she said to me was that she had a Dexcom but hasn’t worn it because battery in transmitter was out for the past 6 months. She told me she really hasn’t been checking her glucose on a regular basis at all.

In part 6 of this Exclusive Interview, understanding how a parent or caregiver can monitor an adolescent who is using the system.

In this week’s Homerun Slides, the effects of hyperinsulinism.

Glucose phosphorylation as a therapeutic target for diabetes: Early experiments using genetic overexpression of glucokinase in liver of rodent models showed promise for the protection against hyperglycemia during diabetes, spawning the development of glucokinase activators. These drugs interact with allosteric sites of glucokinase, thus promoting a conformation that exposes the catalytic domain and potentiates the activity of the enzyme.

Out with the old, in with the old and new?

This sweet treat may be future aid in diabetes treatment.

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