January 12, 2019 : Issue #972

• Effect of Insulin Price on Medication Adherence in Patients with Diabetes
• Comparative Efficacy of Hybrid Closed-Loop Insulin Delivery Systems and Sensor-Augmented Insulin Pumps in Patients with Type 1 Diabetes
• Missing Breakfast and Childhood Obesity
• Association of Severe Hypoglycemia and Cardiovascular Outcomes in Type 2 Diabetes
• How Low Vitamin D Levels Affect Painful Diabetic Peripheral Neuropathy
• Can Automated Text Messages Improve HbA1c?

It is so easy to put reminders in your mobile device that many people fill up their calendar with one reminder after another. I have at least 3 reminders in mine each day. I also have an  app that reminds me to take deep relaxing breaths during the day, as well as one to tell me to squeeze and hold my abs in at random times during the day. There are more for meditation or positive affirmations that many others use.

The problem with these tools is that they either become commonplace or are so generic that patients quickly lose interest and stop using them.

This week we have a study that looks at making these messages more personal and moving them to text messages, so that our patients will be more likely to react positively.

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We can make a difference!

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Dave Joffe

Editor-in-chief

How do you choose the best, affordable treatment for each patient from 6 Million possible combinations for your patients with type 2?

Diabetes in Control is working with an endocrinologist and computer specialist who have developed a program to help you in deciding the best treatment option to manage blood glucose that the patient can afford using their insurance. They are looking for medical professionals to use it and provide feedback.

Would you be interested in learning about a free software that can go through 6 million possible drug combinations for patients with type 2, providing the best options for treatment using the patient’s medical information and insurance? It will rate each combination as to how much it could lower A1c, and provide the cost for each treatment, plus any side effects and even coupons, if available, for the patient to use. This program has already been used for hundreds of patients.
See the software in action in a 9 minute video.

If you’re interested in trying the software, email me at publisher@diabetesincontrol.com.

Follow the link to share your opinion or request more info.

Can you list the 42 factors that can affect blood glucose? From Adam Brown, the senior editor at diaTribe, this list, culminating from his 17 years of living with diabetes, was derived from conversations with experts and scientific research. Download this list of 42 Factors That Affect Blood Glucose (PDF) and print it out for your patients.

When is the HbA1c not reliable?

A. Recent blood transfusion
B. Renal failure
C. Medication use (e.g. aspirin)
D. G6PD deficiency
E. All of the above

Follow the link for the answer.

Research shows that because some women are genetically less able to store fat at the hips, they are at risk of type 2 diabetes and heart disease. The researchers studied the genetic profiles of more than 600,000 women. They identified two specific groups of genetic variants — one that lowers fat around the hips and another increasing fat around the waist and belly.

The new research showed that putting on weight around the hips is actually safer than accumulation around the belly or around other major organs, such as the liver or pancreas. The reason could be because some women are genetically less able to store fat at the hips, which puts them at risk of type 2 diabetes and heart disease. Also, putting on fat is more likely to circulate in the blood. “This means that individuals with this genetic make-up preferentially store their excess fat in the liver, muscles or pancreas, or in their blood in the form of circulating fats and sugar, any of which can lead to a higher disease risk,” said Luca Lotta, lead researcher from the University of Cambridge. “It may seem counterintuitive to think that some people with less fat around their hips are at higher risk of diabetes or heart disease,” said Lotta. The findings, published in the JAMA medical journal, showed that both of the genetic variants identified were associated with higher risk of type 2 diabetes and heart attacks. Genetics, which specifically change fat distribution by lowering fat storage around the hips, increase risk of disease independent of, and in addition to, mechanisms that affect abdominal fat storage, the study noted. — JAMA. 2018; 320(24):2553-2563. doi: 10.1001/jama.2018.19329

High cost associated with underuse in certain patient populations, particularly those with lower incomes.

How does the newest insulin delivery method compare to an established system?

Study targets breakfast habits of parents and its effects on their children.

Trial assesses if link exists between severe hypoglycemia and adverse cardiovascular outcomes in veterans.

Low levels thought to contribute to pathogenesis of painful diabetic peripheral neuropathy due to action on dorsal root ganglia.

Personalized messages based on motivational interviewing principles compared to usual care to determine if any significant difference in self-management of type 2 diabetes.

Quote of the Week!

“If you change the way you look at things, the things you look at change.”

….Wayne Dyer

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

Michael Zaccaro, Pharm. D. Candidate 2019, LECOM School of Pharmacy

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

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

Michael Zaccaro, Pharm. D. Candidate 2019, LECOM School of Pharmacy

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