March 13, 2018 : DCMS #388

DISASTERS AVERTED — Near Miss Case Studies

Finding Success with Food Logging

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dr. Ralph Defronzo on The Effectiveness of Triple Therapy

HOMERUN SLIDES — Great Clinical Presentation Highlights

Hypertension Update 2018 Part 1

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #116: Diabetes and Sleep Apnea Part 6

MOST POPULAR ARTICLES OF THE MONTH

#1 Elevated A1C? Consider Lowering Insulin
#2 A Summary of ADA’s New 2018 Standards of Medical Care in Diabetes
#3 SGLT2 Inhibitors in Treatment of Type 1

Recently the AHA and ACC tightened up their guidelines for better control. These controls are especially important for diabetes patients. This week, one of our favorite presenters, Dr. Claude Lardinois, M.D., FACP, FACE, MACN, who was recently elected as a Fellow of the American College of Endocrinology, starts a series of Homerun slides on hypertension and all the factors and results of our hard work and why we have to try harder to do better for our patients’ sake.

Dave Joffe

Editor-in-chief

Woman, 55 years of age, referred to me for obesity management. She visited without recent labs, so we got started with the agreement she would get her labs drawn soon after her visit. At our first visit, her blood pressure was 150/98, HR 64, and weight 204, BMI-35, therefore her BMI category was class II obesity. PMH-+Migraine Headaches. FH-+Mother died of lung cancer. Her mother was a smoker. Patient is not.

Dr. Ralph Defronzo, MD, speaks about the current variability of diabetes medication as well as their effectiveness but lack of affordability, and he places a special emphasis on the effectiveness of triple therapy in the treatment of diabetes. Dr. Defronzo is a Professor of Medicine and Chief of the Diabetes Division at the University of Texas Health Diabetes Center in San Antonia, Texas. Dr. Defronzo is also Deputy Director of the Texas Diabetes Institute.

In this week’s Homerun Slides, Dr. Claude Lardinois returns with an update on hypertension starting with causes, risk factors, and worldwide mortality rates.

OSA and incident T2DM: Several studies have examined whether having OSA increases the individual’s risk of developing T2DM, in particular whether obesity is a major risk factor for both conditions and whether OSA has been associated with IR and prediabetes as described earlier. Several cross-sectional studies found a higher prevalence of T2DM in patients with OSA despite adjusting for confounders, particularly age and obesity; these studies are reviewed in. Whether OSA is a predictor of T2DM has been examined in a small number of longitudinal studies that used a variety of methods to diagnose OSA (from symptoms to polysomnography), and to diagnose T2DM (from self-reported to OGTT).

This Disaster Averted is not just about one patient but about many who take insulin. Most think high A1C means one needs to increase insulin. Not always! Remember, A1C is an average. Just because someone has an A1C of <7% doesn't actually mean glucose is managed.

Comprehensive recommendations feature notable new recommendations for people with cardiovascular disease and diabetes.

Meta-analysis explores safety and efficacy of sodium-glucose co-transporter 2 inhibitors in patients with type 1 diabetes.