Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.
Letter from the Editor
Have you ever told your child to do something right one time, and then they did it correctly forever? If you are like most of us, that never happens. Yet this week CMS announced that they were applying this concept to diabetes education for Medicare age patients with an A1c of 5.7 to 6.4. They are making the Diabetes Prevention program available to these patients as a covered benefit.
Sounds like a great idea, but they can have it only once in their lifetime, and we all know that concept works so well that once a patient is educated they follow all the guidelines for the rest of their lives.
Oh and if you believe that, I have a bridge between two boroughs of New York I want to sell you cheap!
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We can make a difference!
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Dave Joffe
Editor-in-chief
Newsflash: Medicare Adds Diabetes Prevention as A Benefit
Beginning April 1, the expanded model of the Medicare Diabetes Prevention Program will be added as a covered benefit for beneficiaries who are enrolled in Part B and have A1C levels between 5.7% and 6.4%, body mass index of at least 25, a two-hour plasma glucose of 140 to 199 mg/dL or fasting plasma glucose of 110 to 125 mg/dL, according to the CMS. Patients may use the program only once in their lives and it will be offered for a total of two years, the final rule states.
This Week's Survey
Which do you feel plays a more important role in the health of your patients with diabetes?
1) Nutrition
2) Exercise
3) Both
Patient App
This app by G.P. Imports, Inc. is an easy way for patients to record and keep track of diabetic information.
Current Video
Dr. Sam Engel is the Associate Vice President, Cardiometabolic and Women’s Health at Merck Research Laboratories. He graduated from New York University School of Medicine. Prior to joining Merck’s team, he was a Clinical Professor at Albert Einstein College of Medicine.
Test Your Knowledge
Your patient has been taking metformin, glipizide, and a daily basal insulin dose (.85 U/kg/day). While his fasting glucose levels are on target, he has not yet been able to reach his individualized glycemic target of A1C<7%. In your discussion with him about the addition of a prandial insulin dose to his regimen, you compare and contrast his options. Compared to basal insulin alone, premixed insulins: A. tend to lower A1c to a larger degree. B. are associated with less weight gain. C. cause less hypoglycemia. D. are a good option for people with irregular meal schedules. Follow the link to see the right answer.
Did You Know: Preventing Diabetes with Omega-6 Fat
According to a new study, those who had the highest level of linoleic acid (Omega-6 fat) were 35% less likely to develop type 2 diabetes than those who had the least amount. The results of the study was published in the Lancet Diabetes & Endocrinology Oct. 11, 2017. Current studies have suggested that omega-6 fat can be harmful to health, due to inflammation, which can lead to an increased risk of chronic diseases. But, the study found that those with the highest blood levels of linoleic acid, (omega-6 fat) were 35% less likely to develop type 2. Those in the study were not given information on what or what not to eat and those involved in the study were generally healthy. The study found that those with the highest level of blood omega-6 markers had a much lower chance of getting type 2 diabetes. Data was analyzed from 20 prospective cohort studies from ten countries including the United States. Biomarkers were sampled between 1970 and 2010 from phospholipids, total plasma or serum, cholesterol esters, and/or adipose tissue. The study included 39,740 adults with mean patient age range from 49 to 76 years with a body mass index (BMI) of 23.3–28.4 kg/m2 who did not have T2DM. Over 366,073 person-years of follow-up the researchers identified 4,347 cases of incident T2DM. A multivariable analysis of pooled data showed that higher proportions of linoleic acid biomarkers as percentages of total fatty acid were associated with a lower risk of T2DM overall. The associations between linoleic acid and arachidonic acid biomarkers and the risk of T2DM were not significantly modified by any potential confounding factors, including age, BMI, sex, race, aspirin use, omega-3 PUFA levels, or variants of the fatty-acid desaturase (FADS) gene, which is strongly associated with omega-6 PUFA levels. Omega-6 fat is found in bean and seed oils, such as soybean and sunflower oils, and in nuts. Linoleic acid is not formed in the body and can only be obtained from the diet. US dietary guidelines recommend between 5% to 10% of energy should be derived from polyunsaturated fats. The results suggest that eating foods rich in linoleic acid may lower risk of T2DM, the researchers stated. The Lancet Diabetes & Endocrinology
Vitamin D supplementation could possibly reduce the risk of type 1 diabetes in susceptible children.
New study suggests packaged food claims like “reduced in sugar” or “no added sugar” still have sugar levels too high by World Health Organization standards.
New insulin formulation emerges as safe alternative to long-acting insulins and inconsistent glycemic levels, but could have higher risk of cardiovascular events.
Patients who discontinue their daily aspirin for heart disease prevention may be at risk of further complications.
Screen-based media in a child’s room found to have an independent risk factor for overweight and increased body fatness.
Quote of the Week!
“Good ideas are not adopted automatically. They must be driven into practice with courageous patience.”
…Hyman Rickover
Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletter:
Jessica Quach, Doctor of Pharmacy Candidate; GA-PCOM School of Pharmacy
Kay Lynn Tran, Doctor of Pharmacy Candidate: Class of 2018; LECOM College of Pharmacy
Your Friends in Diabetes Care
Steve and Dave
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