August 28, 2018 : DCMS #412

DISASTERS AVERTED — Near Miss Case Studies

Diabetes and/or Obesity: Whose Fault Is It?

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

George Bray on the Chronic Disease of Obesity

HOMERUN SLIDES — Great Clinical Presentation Highlights

Eversense CGM System Part 2

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #140: The Genetics of Type 2 Diabetes Part 2

MOST POPULAR ARTICLES OF THE MONTH

#1 Vitamin D Supplementation for Diabetes Prevention
#2 37-Year-Old Hypertensive Drug Improves Beta Cell Function and Insulin Production
#3 Empagliflozin’s Effect on Liver Fat

In our Saturday newsletter we had a great feature about how weight loss in certain patients can cause reversal of diabetes.

This week in our Mastery newsletter, Medical Editor Joy Pape shares her candid interview with Dr. George Bray, Professor of Medicine Emeritus at LSU, that she did at the recent AACE meeting. During this review he delves into the problems and processes of obesity and why solving the problem is not as simple as pushing yourself away from the table.

If you need to have a little background to better grasp what the good doctor is saying then you may want to check out this week’s clinical text discussing the Heritability of Type 2 Diabetes.

Dave Joffe

Editor-in-chief

Many people who have diabetes, especially type 2 diabetes, tell me they have no one to talk with about their diabetes. Why, with all the education and tools we have, do people who have diabetes still feel this way?

My patients who have excess weight or obesity tell me the same thing. We may not have as much clinical information on that as we do diabetes as of yet, but the patients tell me the same thing.

George A. Bray, M.D., MACP, MACE is a Boyd Professor Emeritus at the Pennington Biomedical Research Center of Louisiana State University in Baton Rouge, Louisiana, and Professor of Medicine Emeritus at the Louisiana State University Medical Center in New Orleans.  After graduating from Brown University summa cum laude in 1953, Bray entered Harvard Medical School graduating magna cum laude in 1957. His post-doctoral training included an internship at The Johns Hopkins Hospital, Baltimore, MD, a fellowship at the NIH, residency at the Strong-Memorial Hospital, University of Rochester, a fellowship at the National Institute for Medical Research in London and at the Tufts-New England Medical Center in Boston.   In 1970, he became Director of the Clinical Research Center at the Harbor UCLA Medical Center, and organized of the First Fogarty International Center Conference on Obesity at NIH in 1973. Bray also Chaired the Second International Congress on Obesity in Washington DC in 1977. In 1989 he became the first Executive Director of the Pennington Biomedical Research Center in Baton Rouge, a post he held until 1999. He is a Master of the American College of Physicians, Master of the American College of Endocrinology and Master of the American Board of Obesity Medicine. Bray founded the North American Association for the Study of Obesity in 1982 (now The Obesity Society), and he was the founding editor of its journal, Obesity Research, as well as co-founder of the International Journal of Obesity and the first editor of Endocrine Practice, the official journal of the American College of Endocrinologists.

In this week’s Homerun Slides, explaining how the Eversense CGM System works.

Heritability of T2DM: It has long been clear that T2DM clusters in families and it is well established that the risk of developing T2DM depends on both genetic and environmental factors. However, the exact proportion of the two, that is, the heritability, is difficult to determine and heritability estimates therefore vary in the range of 25–80% between studies. Twin-studies have estimated the genetic component by comparing disease concordance in dizygotic twins with concordance in monozygotic twins. In these studies probandwise concordance rates (number of affected twins having a diabetic co-twin) for monozygotic twins vary between 34 and 100%.

Vitamin D shows potential to lower HbA1c, FPG, insulin resistance, and 2-hour post-prandial glucose levels.

Researchers discover safe and effective therapy to reduce insulin requirements and hypoglycemic episodes in adult subjects with recent onset type 1.

An SGLT-2 inhibitor reduces liver fat and ALT levels in people who have type 2 diabetes.