May 23, 2017 : DCMS #346

DISASTERS AVERTED — Near Miss Case Studies

Concentrated Insulin Pens and the Visually Impaired

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Michael Hill Part 9, Feedback and Cost

HOMERUN SLIDES — Great Clinical Presentation Highlights

Insulin & Vascular Function Part 5

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #75: Insulin actions in vivo: glucose metabolism Part 1 of 9

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There has been a lot of press lately about the high cost of insulin, and even Congress has called the leaders of insulin companies to task for the prices. Some of the companies have linked up with discount programs like Blink to make insulin more affordable, and the companies themselves are offering free or reduced prices with copay assistance cards. These cards have been a blessing for many patients but for some they can cause problems, as seen in this weeks Disaster Averted.

Dave Joffe

Editor-in-chief

An endocrinologist prescribed a U-200 TRESIBA (insulin degludec) pen for an 88-year-old woman with labile type 1 diabetes and recurrent hypoglycemia. The patient also has severe macular degeneration with visual impairment. Visually impaired patients commonly use touch and sound to assist them.An endocrinologist prescribed a U-200 TRESIBA (insulin degludec) pen for an 88-year-old woman with labile type 1 diabetes and recurrent hypoglycemia. The patient also has severe macular degeneration with visual impairment. Visually impaired patients commonly use touch and sound to assist them.

Michael Hill talks with Diabetes in Control Publisher Steve Freed during a Skype interview. In part 9, the conclusion of this Exclusive Interview, the response of trial participants who used the closed-loop system and managing the costs.

n this week’s Homerun Slides, finding the common ground between – and possible path to treatment of – hyperglycemia and the causes of vascular disease.

Glucose is widespread in living organisms and, with protein and fat, completes the triad of the major metabolic fuels. To a much lesser extent than in plants, glucose also constitutes a building block for structural and enzymatic components of cells as well as the extracellular matrix. As a metabolic substrate, glucose is present in organisms essentially in its simple, monomeric form (alpha-D-glucopyranose) and as a branched polymer of alpha-glucose, namely glycogen. Disaccharides of glucose (lactose, maltose, and sucrose) are quantitatively less important. Glucose is present in plasma water at a concentration that — in a healthy adult who has fasted overnight — ranges between 3.6 and 5.5 mmol L−1 (65 – 99 mg dL−1 ).

This sweet treat may be future aid in diabetes treatment.

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

In a departure from recommendations by cardiology societies, two endocrine groups issue new lipid-management guidelines that bring back LDL-cholesterol targets.