March 24, 2018 : Issue #930

• Exclusive Analysis: How Patients and HCPs Really Feel About CGMS
• Losing Weight In Midlife Reduces Diabetes Risk Later in Life
• Sex Differences in Cancer Incidence in Type 2 Diabetes
• Beta-blockers Effect on Patients with Diabetes, Chronic Heart Failure
• What Are We Doing To Prevent Type 2 Diabetes?
• Lower Death Risk with SGLT2 Inhibitors in Patients with Type 2 Diabetes
• David Zeng on the iWel CGM

I saw a news blurb on NBC last night talking about the need for physical exercise and how an hour a day would be great. The interviewee was saying if you broke the hour up into 4 or 5 segments the results would be just as robust as taking an hour all at once. That got me thinking about how few of our patients get any exercise at all, and if they really understand how important physical activity could be.

It is interesting that this week we have an item that looks at this conundrum and brings in real numbers why we should do more lifestyle interventions. Check out item #5 for details.

*****************************

We can make a difference!

*****************************

Dave Joffe

Editor-in-chief

Using a CGMS for type 2 diabetes can be very beneficial for type 2 patients not using insulin. Do you agree or disagree? Follow the link to share your opinion.

Abbott just launched its FreeStyle LibreLink app; it’s now available in 12 European countries on the iPhone 7 or later and Android phones. FreeStyle LibreLink allows FreeStyle Libre continuous glucose sensor users to read their blood sugar data directly on a smartphone – no separate handheld reader device required. Just like the current reader device, the app allows users to start a new sensor and to obtain a real-time blood sugar reading and trend arrow at any time by “scanning” the sensor (i.e., holding the phone within a few inches of the on-body patch). See how the App works

Diabetes in Control speaks with top endocrinologists and other medical professionals to bring you the latest in diabetes news and research. This week, we have another exclusive interview from the ADA 2017 Scientific Sessions in San Diego, CA. David Zeng, PhD, is CEO of Glutalor Medical Inc. in Philadelphia, PA. Glutalor Medical Inc. manufactures and …

Mrs. O’Doole is a 34 year-old of Irish descent. She works as a florist who and is married with three children. She arrives at your clinic for her annual wellness exam. Her blood pressure is 130/84 mmHg, pulse 65, BMI 24 kg/m2 and her physical exam is notable for acne and mild hirsutism. Her only current medication is oral birth control pills. She recalls starting OCP, 15 years prior, due to irregular menses.

Based upon her medical history and physical, you believe it would be prudent to screen Mrs. O’Doole for type 2 diabetes. You discuss your recommendations with her and she agrees to be tested. The lab returns a fasting plasma glucose (FBG) of 112 mg/dL. You share these results with your patient and inform her, that while only mildly elevated, she has impaired fasting glucose.

What is the best choice for initial management of Mrs. O’Doole’s prediabetes?

A. Metformin
B. Metformin+ Pioglitazone
C. Lifestyle modifications + Pioglitazone
D. Lifestyle modifications (dietary modifications, weight loss and exercise)

Follow the link for the answer.

According to the International Diabetes Federation, it is estimated that the prevalence and burden of diabetes worldwide in 2017 is at least 451 million adults living with diabetes, another 374 million adults had prediabetes and at least 374 million deaths were caused by diabetes. If you are looking at the cost of diabetes, it is estimated to be over 850 billion dollars. Looking into the future, they estimate that by 2045, 893 million people will be living with diabetes worldwide. A systematic literature review was conducted to identify published studies on the prevalence of diabetes, impaired glucose tolerance, and hyperglycemia in pregnancy in the period from 1990 to 2016. The highest quality studies on diabetes prevalence were selected for each country. A logistic regression model was used to generate age-specific prevalence estimates or each country. Estimates for countries without data were extrapolated from similar countries. Assuming low incidence and relatively high diabetes mortality, total diabetes prevalence (diagnosed and undiagnosed cases) is projected to increase from 14% in 2010 to 21% of the US adult population by 2050. However, if recent increases in diabetes incidence continue and diabetes mortality is relatively low, prevalence will increase to 33% by 2050. A middle-ground scenario projects a prevalence of 25% to 28% by 2050. Intervention can reduce, but not eliminate, increases in diabetes prevalence. It has been concluded that these increases are largely attributable to the aging of the population. Effective strategies will need to be undertaken to moderate the impact of these factors on national diabetes burden.  DOI: https://doi.org/10.1016/j.diabres.2018.02.023

Both patients with diabetes and health care professionals expect wider adoption of continuous glucose management systems in the future for patients with type 2 as well as type 1, and agree that cost is a key factor in patient choices

Risk of diabetes diagnosis higher in those who lost weight after age 25, but study finds result statistically insignificant.

Men and women with type 2 have different risk for obesity-related cancer when compared with general population.

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

Only 3.1% Americans engage in activities to prevent a diabetes diagnosis.

It is unclear whether SGLT2i show reduction in mortality in all patients with type 2 or just in patients with type 2 diabetes with increased cardiovascular risk.

Quote of the Week!

“I think we all have empathy. We may not have enough courage to display it.”

…Maya Angelou

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

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

Vidhi Patel, Pharm. D. Candidate 2018, LECOM College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
810 Bear Tavern Road Suite 102
Ewing, NJ, 08628
USA
www.diabetesincontrol.com