May 20, 2017 : Issue #886

• Current Video Interviews: Dr. Andrew J.M. Boulton, MD, DSc, FRCP
• FDA: Boxed Warning: Amputation Risk for Canagliflozin
• Breastfeeding Helps to Prevent Type 1 Diabetes
• GLP-1 Receptor Agonist for Type 1’s
• Effects of Adding Metformin to Insulin in Type 1 Children and Adolescents
• Liraglutide Reduces Liver Fat Content in Patients With Poorly Controlled  Type 2 Diabetes

I am sitting in the airport in Baltimore waiting to head back to Saint Petersburg. I was here to attend the PQA annual meeting. During this meeting, we heard from professional leaders as they discussed the progress that the Pharmacy Quality Assurance organization had made in ensuring better patient care and higher star ratings. While I was waiting on the flight, I caught up with emails and calls. Once this was finished, I realized that I still had over an hour ’til my plane departed.

It was the perfect time to lean back and watch some video interviews that Steve had done with key diabetes leaders at the recent AACE meeting. In this 6-part series, Dr. J.M. Boulton, MD, DSc, FRCP, Professor of Medicine, at the University of Manchester shares his ideas on a wide range of subjects from the state of diabetes today to 2018 and beyond. Be sure to check them out.

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We can make a difference!

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Dave Joffe

Editor-in-chief

The US Food and Drug Administration (FDA) has issued a new boxed warning to the label of canagliflozin (Invokana, Invokamet, Janssen) to describe the risk for leg and foot amputations. — new safety alert (See Article 1)

To your type 1 patients who use large amounts of insulin or are overweight, have you recommended the use of a GLP-1 receptor agonist in their treatment? (See Article #3)
1) Yes
2) No
3) No, but will now consider

What do your colleagues think? Follow the link to find out!

Diabetes Core Update is a monthly audio podcast devoted to presenting and discussing the latest clinically relevant articles from the American Diabetes Association’s four scholarly journals: Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 20 minutes long and presents 5–6 recently published articles from ADA journals. Intended for the busy health care professional who has little time to review journal articles in depth, Diabetes Core Update discusses how the latest research and information published in ADA journals are relevant to clinical practice and can be applied in a treatment setting.  Diabetes Core Update audio podcasts are FREE and can be accessed through Diabetes Core Update Podcasts

What proportion of Americans age 45 and older have self-reported memory problems?

1. 1 in 30
2. 1 in 16
3. 1 in 9
4. 1 in 4

Follow the link to see the correct answer!

Researchers find that extreme cold reduces risk while heat increases risk of diabetes. According to a published study in the May 15th journal of Canadian Medical Association, it looks like the outdoor temperature can influence a pregnant woman’s risk of developing gestational diabetes. Cold-induced thermogenesis is known to improve insulin sensitivity, which may become increasingly relevant in the face of global warming. The aim of this study was to examine the relation between outdoor air temperature and the risk of gestational diabetes mellitus. Over the 12-year period, there were 555,911 births among 396,828 women. Prevalence of gestational diabetes mellitus was 4.6% among women exposed to extremely cold mean outdoor air temperatures (≤ −10°C) in the 30-day period before screening and increased to 7.7% among those exposed to hot mean 30-day temperatures (≥ 24°C). Each 10°C increase in mean 30-day temperature was associated with a 1.06 (95% confidence interval [CI] 1.04–1.07) times higher odds of gestational diabetes mellitus, after adjusting for maternal age, parity, neighborhood income quintile, world region and year. A similar effect was seen for each 10°C rise in outdoor air temperature difference between 2 consecutive pregnancies for the same woman (adjusted odds ratio 1.06, 95% CI 1.03–1.08). From the findings, it was interpreted that there was a direct relation between outdoor air temperature and the likelihood of gestational diabetes mellitus. Future climate patterns may substantially affect global variations in the prevalence of diabetes, which also has important implications for the prevention and treatment of gestational diabetes. — CMAJ May 15, 2017 vol. 189 no. 19 doi: 10.1503/cmaj.160839

Post-marketing trial data show doubled rates compared to placebo.

Youths who received any breastfeeding for at least 12 months or full breastfeeding for at least six months had lower odds of developing type 1 diabetes.

Besides lowering A1c, study finds success with using less insulin and weight reduction.

A low-risk intervention with potentially high rewards.

A proposed benefit of GLP-1 agonists confirmed in a human study.

Dr. Andrew J.M. Boulton, MD, DSc, FRCP, Professor of Medicine, University of Manchester speaks with Diabetes in Control publisher Steve Freed about the global epidemic of diabetes.

Quote of the Week!

“There is only one corner of the universe you can be certain of improving, and that’s your own self.”

…Aldous Huxley

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