May 30, 2017 : DCMS #347

DISASTERS AVERTED — Near Miss Case Studies

Not All Insulins and Not All Syringes are U-100

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dave Viegerust: Molecular Diagnostics for Cardiovascular Risk

View Video | Read Transcript

HOMERUN SLIDES — Great Clinical Presentation Highlights

Insulin & Vascular Function Part 6

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #76: Insulin actions in vivo: glucose metabolism Part 2 of 9

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The use of glucose in the body has taken on a lot of new points in the last few years, as we learn more about the effects of organs such as the kidney and the small intestines. Very often we talk about steady state glucose and how for a lot of patients we can’t figure out why our best efforts don’t get the glucose levels we are looking for.

These problems likely have more to do with glucose metabolism instead of glucose control. This week our clinical text from the International Textbook of Diabetes Mellitus delves into the nuances of glucose metabolism, and why a better understanding of the processes and malfunctions will likely improve patient care.

Dave Joffe

Editor-in-chief

Problems associated with the use of U-500 insulin syringes. We received two reports of accidental prescribing of the new BD U-500 insulin syringes for outpatients who were using a U-100 insulin product. In one case, an endocrinology clinic called the hospital pharmacy to ask how to order U-500 syringes. During the conversation, it became apparent that there was some confusion about the use of these syringes. The pharmacist stressed that the patient should not use a U-500 syringe to measure any insulin concentration other than U-500, or the measurement would be incorrect, leading to a 5-fold underdose.

Dave Vigerust discusses why patients with diabetes who have a particular genotype of haptoglobin are at a significantly higher risk of a coronary event.

In this week’s Homerun Slides, beta cell failure in type 2 diabetes mellitus and the concept of glucotoxicity.

Glucose metabolism: Introduction. Any given concentration of glucose in plasma (and in the space in equilibrium with plasma) is the result of simultaneous release of glucose into the circulation and uptake of glucose from the bloodstream into cells. Whenever plasma glucose concentration is stable, the concurrent rates of its release and overall uptake must be equal. Glucose turnover (TR) is this rate of constant flux through its system.

This sweet treat may be future aid in diabetes treatment.

Ralph DeFronzo and his researchers at UT Health at San Antonio announced that they have cured type 1 diabetes.

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