February 24, 2018 : Issue #926

• What You Need to Know About SGLT2i Use in Obesity
• Decline in Cognitive Function As Key Factor in Life Expectancy for Person with Diabetes
• Beta-blockers Effect on Patients Who Have Diabetes and Chronic Heart Failure
• Type 2 Diabetes Can Begin 20 Years Prior to Diagnosis
• Impact of Age, Gender, and Diagnosis of T2D on Overall Mortality
• The Coming Debate on Closed-Loop Insulin Delivery Systems
• Exclusive: Jim McDermott on AstraZeneca SGLT-2 Research

Every week we bring you great information on the latest details of new drugs and new studies on old drugs. In fact in 2018 alone we have had over 20 articles on pharmaceuticals.

This plethora of choices and information often overwhelms even the most astute clinician, and when you add in things like comorbidities, prescription cost, drug coverage and the patient’s ability to pay, selecting a proper regimen is totally overwhelming.

For the past 6 weeks we have been featuring a program called GlucosePath. Our publisher, Steve Freed, has worked with the creators to bring you a unique opportunity. He has convinced the developers of the program that recently received 1^st place in the  American Association of Clinical Endocrinologists’ annual conference and poster competition, to let you beta test the program at absolutely no charge. All you have to do is send an email to Steve at publisher@diabetesincontrol.com with your background and purpose for using the software and he will set you up to take advantage of this awesome program.

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We can make a difference!

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Dave Joffe

Editor-in-chief

GlucosePath is a computer program designed to help healthcare providers and patients make decisions about the medical treatment of type 2 diabetes. Awarded 1st place in the  American Association of Clinical Endocrinologists’ annual conference and poster competition. (pdf)(Link to poster),  PATH analyzes millions of potential treatment options in customized patient scenarios to find solutions most likely to succeed.  In a study presented at the AACE Annual conference, charts of 200 patients with type 2 with HbA1c >7 were analyzed for patient characteristics and physician’s decision regarding therapy. Primary care physicians were ranked into three groups based on the average HbA1c in their poorly controlled patients. The PATH software was applied to the pre-intervention patient and compared to the decisions made by physicians.  Results of study:

• Average PATH therapy saves a projected $764/year vs most recent PCP therapy
• Projected A1c level of 6.7 vs 7.4 for most recent PCP therapy
• Composite risk benefit scoring showed 40.1% better results with PATH vs. PCP

In recent issues, we introduced you to this revolutionary software program to help medical professionals and patients evaluate thousands of possible combinations of medications against a standard set of rules, patient insurance plans,  and budgets to offer a set of therapies with a score along with the most important information for patients to know about risks and benefits to help both the patient and physician agree to the test treatment that fits the patient’s goals and accounts for drug interactions, side effects, underlying medical benefits, ease of use and drug costs, which can include the use of manufacturer coupons.

For a short time, we are offering free access and training for the “beta test” version to use for demo, educational purposes, trial or study. If interested email publisher@diabetesincontrol.com with your background and purpose for using the software.

Do you provide any kind of exercise program for your patients?

Follow the link to see how you compare to your colleagues.

The results of the phase 3a PIONEER 1 study for the first oral GLP1 receptor semaglutide showed it was safe and effective for poorly controlled type 2 diabetes, with 80% of patients reaching goal of 7% or less and a reduction in body weight over 26 weeks.

Dr. Jim McDermott is Vice President of US Medical Affairs for Diabetes at AstraZeneca. He has been with AstraZeneca for more than two decades.

According to a recent study, which one of the following diabetes therapies carries a lower risk for adverse cardiovascular (CV) events?

1. Nonspecific, long-acting sulfonylureas (eg, glyburide and glimepiride)
2. Specific, short-acting sulfonylureas (eg, glipizide, tolbutamide)
3. CV risk does not differ between these agents

Follow the link for the answer.

According to researchers who completed a new study on 1,040 adults with type 1 diabetes to determine the potential associations between coffee consumption and metabolic syndrome. The researchers accounted for age (mean age 40 yrs), age at diagnosis, length of diabetes, sex, energy intake, alcohol intake, physical activity, and smoking. They were based into four groups of <1 cup of coffee up to three more groups of 1 cup <3 cups a day, and less than 4 cups a day and then for at least 5 cups a day. Frequency of metabolic syndrome increased with increasing coffee consumption with the lowest rate in non-consumers (51%) followed by low consumers (64%), moderate consumers (65%), and high consumers (70%). Odds of metabolic syndrome were higher in the moderate and high consumer groups compared with the non-consumer group in the logistic regression analysis adjusted for age, sex, energy intake, alcohol intake, physical activity, and smoking. Any level of coffee consumption was associated with increased odds of hypertension, the blood pressure component of metabolic syndrome. Mean estimated glomerular filtration rates increased with increasing coffee consumption, whereas no differences were observed between the groups for estimated glucose disposal rate or high-sensitivity C-reactive protein.

From the results it was concluded that moderate and high coffee consumption is associated with an increased risk of metabolic syndrome, while any level of coffee consumption is associated with higher odds of fulfilling the blood pressure-component of metabolic syndrome.

Stutz B, et al. Nutr Metab Cardiovasc Dis. 2018;doi:10.1016/j.numecd.2018.01.011.

Therapy offers beneficial weight loss in treatment of diabetes, but which agent in the class leads to the greatest body weight reduction?

Diabetes-status in older Americans can lead experts in establishing an association between cognitive impairment and mortality.

Protecting the heart and helping to reduce mortality, a closer look at beta-adrenoceptor inhibition in diabetes.

Subtle elevations in fasting glucose and triglycerides associated with developing type 2 diabetes.

Study conducted in Germany demonstrates all-cause mortality to be doubled in patients with both diagnosed and undiagnosed type 2 diabetes.

Guest Post by David Kliff, Editor, Diabetic Investor

As I left Vienna after attending the 11th International Conference on Advanced Technologies & Treatments for Diabetes, my thoughts turned to what does this all mean, what was the most significant takeaway? By far the most significant development coming out of ATTD is the long quest to have a REAL closed-loop insulin delivery system is no longer a pipe dream. This is going to happen and for once I believe it will happen in my lifetime. It is difficult to overstate the power of the data I witnessed. The reality here is that some very smart people have come a very long way.

Quote of the Week!

“I’ve always believed that you can think positive just as well as you can think negative.”

…James A. Baldwin

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletter:

Lamija Zimic, Doctor of Pharmacy Candidate 2018, USF College of Pharmacy

Adrianna Jackson, Doctor of Pharmacy Candidate 2018, LECOM College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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Ewing, NJ, 08628
USA
www.diabetesincontrol.com