January 1, 2019 : DCMS #430

DISASTERS AVERTED — Near Miss Case Studies

When Newly Diagnosed, It’s Not Just About Taking an Injection

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Katherine Kreider on Diabetes Distress

HOMERUN SLIDES — Great Clinical Presentation Highlights

New CGM Categories and Technologies Part 1

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #158: Immunopathogenesis of Type 1 Diabetes in Western Society Part 1

MOST POPULAR ARTICLES OF THE MONTH

#1 Interview: New Drug Cocktail That Increases Human Beta Cell Proliferation at Rapid Rates
#2 HbA1c Variability and Risk of All-Cause Mortality and Cardiovascular Events
#3 Updated Federal Physical Activity Guidelines: Do They Apply to People with Diabetes?

Many times we think the best technology is what our patients want, but that is not always true. Many times advanced technology means more work, more efforts and a greater acknowledgement of the patient actually taking responsibility for their own care.

If a patient is only on mixed insulin twice a day they really avoid a lot of responsibility. They don’t need to check their glucose or even calculate dosing, so if their A1c is higher or they bottom out it is not really their fault.

This lack of accepting responsibility for their care is often threatened by devices such as CGM and pumps. This week we have a new Homerun slide series to help you with your patients.

Dave Joffe

Editor-in-chief

When starting a patient on insulin, there’s more than just teaching how to give an injection and check glucose levels. Teach insulin’s action and side effects, especially the possibility of hypoglycemia, what it is, how to prevent, recognize and treat it.

Kathryn Evans Kreider, DNP, FNP-BC, BC – ADM is an assistant professor of nursing at Duke University School of Nursing (DUSON). She is the lead faculty member for the new endocrinology specialty for nurse practitioners at DUSON, the first program of its kind for nurse practitioners in the Unites States. She has an active clinical practice as a nurse practitioner in adult endocrinology at Duke and is board-certified in advanced diabetes management. She currently serves as the director for advanced practice providers in the division.

In this week’s Homerun Slides, the benefit of introducing CGM early in a diabetes diagnosis.

Introduction: Type 1 diabetes (T1DM), formerly referred to as insulin dependent diabetes mellitus (IDDM) and juvenile diabetes, is considered a chronic autoimmune disease. Over time, the disease process results in the virtually complete elimination of pancreatic beta cells and lifelong insulin deficiency. In turn, patients become dependent on daily insulin injections to maintain an acceptable level of metabolic control. It is widely accepted that T1DM is a complex, multifactorial disease in which genetic predisposition and environmental exposures promote the triggering of multiple autoimmune responses against beta cells.

Diabetes in Control is pleased to bring you an exclusive interview with Dr. Andrew Stewart. Dr. Stewart and his fellow researchers at the Icahn School of Medicine at Mount Sinai have discovered a novel combination of two classes of drugs that induces the highest rate of proliferation ever observed in adult human beta cells—the cells in the pancreas that produce insulin. The result is an important step toward a diabetes treatment that restores the body’s ability to produce insulin. 

Study assesses effect of variable glycemic levels on risk of vascular complication in patients without diabetes.

In mid-November 2018, the U.S. Department of Health and Human Services finally released new physical activity guidelines (as a 2nd edition) to update their previous set from a decade before. Various activity guidelines for adults with diabetes have been updated several times in the interim, including a 2010 position statement on exercising with type 2 diabetes published jointly by the American College of Sports Medicine and the American Diabetes Association; a 2016 ADA position statement on exercise and physical activity for all types of diabetes; and a consensus statement on being active with type 1 diabetes published in The Lancet in 2017.