November 20, 2018 : DCMS #424

SPECIAL FEATURE: Your Insights Needed for Exclusive Research

Pumps vs. Daily Injections: What’s the Future of Insulin Delivery?

DISASTERS AVERTED — Near Miss Case Studies

When Treating Obesity, Discuss the Holidays — Before, During and After

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Raghu Mirmira on Type 1 Diabetes Research

HOMERUN SLIDES — Great Clinical Presentation Highlights

CGM Review of Clinical Outcomes Studies Part 4

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #152: Monogenic Disorders of the Beta Cell Part 2

MOST POPULAR ARTICLES OF THE MONTH

#1 What Not to Trust
#2 Possible Breakthrough In Treating Type 2 Diabetes and Prediabetes
#3 Updated Patient-Centered Hyperglycemia Guidelines for 2018

Although monogenic disorders of the beta cell account for only 1–2% of all diabetes, they are bound to show up sometime in your practice. They are discrete disorders that are a significant cause of diabetes in their own right. This week, in our Clinical Text, we begin a discussion of the three major types, with an overview of MODY. If you want to learn more about monogenic disorders in general, check out Part 1 from last week’s Clinical Text.

Also, our Medical Editor, Joy Pape, RN, MSN, FNP, CDE, FAADE spent last week in Nashville for the joint collaboration of The Obesity Society’s (TOS) and the American Society for Metabolic & Bariatric Surgery’s (ASMBS) Obesity Week 2018.  ObesityWeek brings together world-renowned experts in obesity to share innovation and breakthroughs in science unmatched around the globe. This year, the international conference focused on the heart, the cardiac component of obesity, and of course a lot of information regarding diabetes.

Today, we share her interview with Dr. Scott Kahan MD, MPH, Director of the National Center for Weight and Wellness, Faculty at Johns Hopkins Bloomberg School of Public Health, from the American Association of Clinical Endocrinologist’s (AACE) 2018 annual meeting. Who recently accepted the position of joining DiabetesInControl’s Advisory Board.

Joy and Dr. Kahan look forward to share evidence based science about the disease of obesity and scientifically sound treatments to help you and your patients differentiate between the hype and evidence based treatment strategies.

Dave Joffe

Editor-in-chief

It’s not unusual for people who have excess weight or obesity to have many barriers to overcome in managing their weight. In my experience, the holiday season can be a big barrier. For much of the world, holidays are associated with food; not just food but an overabundance of food. And for many, the weather is cold at this time of the year, which doesn’t help with being active.

Raghu Mirmira, MD, PhD, is the director of the Center for Diabetes and Metabolic Diseases (CDMD) at Indiana University School of Medicine. Under his leadership, the NIH-funded CDMD at IU School of Medicine strives to transform health through basic and translational research while preparing healers with enhanced opportunities in diabetes research and scientific discovery. The focus of Dr. Mirmira’s research is the pathogenesis of diabetes mellitus and the biology of the islet. His most recent areas of interest include islet stress pathways in Type 1 diabetes and how these pathways contribute to the production of neoantigens and the activation of autoimmune responses.

In this week’s Homerun Slides, understanding the DIAMOND study of people with type 1 and type 2 diabetes.

Maturity-onset diabetes of the young (MODY) refers to group of monogenic subtypes of diabetes characterized by young onset (usually before 25 years) of non-insulin-dependent diabetes, beta-cell dysfunction that is inherited as an autosomal dominant trait. Mutations in at least 10 genes have been found to cause MODY; the common subtypes are due to mutations in GCK, Hepatocyte nuclear factor 1-alpha (HNF1A), HNF4A, and HNF1B. The definition of the underlying genes has resulted in the recognition of distinct clinical and physiologic subgroups of MODY with varying clinical course, prognosis, and treatment requirements. Classifications of diabetes by the ADA and the WHO recognize these discrete subtypes.

Diabetes in Control readers are being asked to participate in exclusive research that will provide new insights into what you think about insulin pumps and daily injections. Whether you’re a patient, a patient family member, medical professional or diabetes educator, we need to hear from you.

Please take a few moments to take our survey and help our research. The survey takes only about 3 minutes, is completely anonymous, and lets you make your voice heard in analysis that can potentially influence the future of insulin delivery research and development.

I received a call and glucose numbers from patient who has type 2 diabetes, usually with hyperglycemia, never hypoglycemia. I noticed there was at least a 12-hour span since the last glucose reading. His glucose levels after the over-12-hour lag showed hypoglycemia during the  night when the numbers start showing. His glucose averaged 53 during that time, but it has been running 150 and over, and we have been slowly increasing his insulin.

Free potential treatment lowers blood sugars, helps with weight loss, drops blood pressure and cholesterol, and may add at least 10 years of quality of life.

Holistic approach revised, but there is still more to be done to individualize treatment.