September 29, 2018 : Issue #957

• Update: SGLT2 Inhibitors Linked to Outbreaks of Rare Fournier’s Gangrene
• Liraglutide Lowers Risk for Amputation in Patients with Type 2 Diabetes and CV Risk
• Probiotic Therapy May Show Benefits in Type 2 Diabetes
• Pre-exercise Breakfast May Allow for Increased Glycemic Management
• Benefits vs. Risk of Aspirin Use in Diabetes
• Weight After Smoking Cessation Linked with Increased Risk of Type 2 Diabetes

20 years ago when I was dispensing medications in a retail setting, it seemed like we handed out antibiotic prescriptions at least 50% of the time. This overuse without a reason often led to antibiotic resistance, and secondary a lot of yeast and fungal infections. Pharmacists often would recommend that patients eat yogurt to try to reestablish the correct bacterial flora. The problem with yogurt is that often the processed grocery store variety had little or no live cultures, or the patients could not stand to eat it.

Now we have supplements with these active cultures that make it easy for anyone to try to establish a correct flora. These probiotics, as they are called, along with prebiotics like inulin and soluble fibers, are recommended for many patients with gastric distress and reflux as well as an adjunct for weight loss.

Our PharmD Candidate from USF, Melissa Bailey, has found out that this same probiotic therapy can be very beneficial to our patients with type 2 diabetes, helping to improve insulin sensitivity and vessel inflammation, among a list of things. To see how recommending probiotics may be a powerful therapy for your patients, click here.

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We can make a difference!

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Dave Joffe

Editor-in-chief

From your experience: What do you tell your CGM patients they should consider?

A. Determining how long it takes for a change in basal to have an impact on glucose
B. Monitoring 2-hour postprandial excursion to see how well bolus worked
C. Formally testing basals by skipping a meal
D. A and B
E. A, B, and C

Follow the link to share your experience.

After two decades of advocacy by ADA, the U.S. Department of Transportation Federal Motor Carrier Safety Administration (FMCSA) released its long-awaited Final Rule on diabetes. The new rule permits individuals with insulin-treated diabetes to be certified to operate commercial motor vehicles in interstate commerce.

To learn more, read here.

Download the Federal Motor Carrier Safety Regulations.

The Gen 3 System’s off-the-shelf Android phone offers a significant improvement in form, factor, and user experience with a lighter, slimmer, more modern version of its current handset controller.

It provides the quality and responsiveness that is to be expected from consumer-grade smartphones, while preserving the high-level of security of a medical-grade device. Moreover, a new user interface brings a fresh, contemporary design to the system. Its battery life has been extended beyond 48 hours on a single charge. To learn more: Cellnovo

An FDA safety notice issued Sept. 28, 2018 urged patients, health care providers and caregivers to be aware of the correct usage of insulin pen needles and the possible risks associated with the failure to remove the standard pen needle’s inner needle cover before injecting insulin. This is a safety issue Diabetes in Control has featured more than once in our “Disasters Averted” features. See We Repeat: Teach To Remove The Needle Shield! and Know Your Pen Needles for more on this topic.

Which one of the following supplements has been shown to reduce the risk for stroke and cardiovascular disease (CVD)?

A. Vitamin D
B. Calcium
C. Vitamin C
D. Folic Acid
E. Niacin

Follow the link for the answer.

After diagnosis of type 1 diabetes, 60% of adults experience a period of partial remission, or “honeymoon” period, characterized by low insulin requirements and good glycemic management. The honeymoon period is attributed to two factors: partial recovery of beta-cell function and normalization of insulin sensitivity. Both decline with type 1 diabetes, bringing the honeymoon period to a natural close. In a newly published study, it was concluded that, among men with new-onset type 1 diabetes, exercise can play a role in extending the “honeymoon” period of partial remission after diagnosis.  In a small retrospective study, 16 men identified with type 1 diabetes began physical activity at the time of diagnosis and continued through follow-up. The researchers found that men who performed substantial exercise had a type 1 diabetes honeymoon period that is more than five times longer than that of sedentary men. — Chetan MR, et al. Diabet Med. 2018;doi:10.1111/dme.13802.

FDA issues new warning regarding SGLT2 inhibitors after 12 cases of rare necrotizing fasciitis emerge.

Investigators find patients treated with GLP-1 drug had significantly lower number of amputations compared to placebo group.

Recent study shows improvements in insulin resistance and endotoxin-induced inflammation after taking probiotic supplementation, compared to placebo.

New study shows that consuming breakfast prior to exercise lowers insulin levels at subsequent meals.

Recent study demonstrates prevention of serious vascular events with aspirin use; however, participants also experienced major bleeding events.

Recent studies show continued benefit in decreasing all-cause mortality from cardiovascular disease.

Quote of the Week!

“Success is not final, failure is not fatal: it is the courage to continue that counts.”

…Winston Churchill

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

Melissa Bailey, Pharm.D. Candidate, USF College of Pharmacy

Clarke Powell, Pharm.D. Candidate 2019, LECOM School of Pharmacy

Your Friends in Diabetes Care
Steve, Dave, and Joy
Diabetes In Control
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