June 20, 2020 : Issue #1047

TOP STORIES — Diabetes News and Research

Study Provides Insight Into Dual and Triple Therapy Options for Diabetes

Predicting Diabetes Risk in Men

New Findings on the Relationship Between Teen BMIs and Diabetes

For years the mantra in type 2 diabetes care was “start low go slow.” This seemed to make sense when most patients were diagnosed in their late 50’s or early 60’s.

Now we see many new patients in their 30’s and 40’s, and so we need to get more aggressive in treatment. The question is, which medications should we mix together to get the maximum effect with the minimum risk? This week our University of Colorado intern David Clarke has the results of a large study that will help you decide which medications to select.

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We can make a difference!

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Dave Joffe

Editor-in-chief

Danish study makes strong recommendations for diabetes pharmacotherapy beyond metformin. 

Lower percentages of lean body mass have shown correlation to a higher risk of diabetes in older men.

Body mass in adolescence affects risk of developing type 2 as an adult. 

In a study published on June 11 in The Journal of Clinical Endocrinology & Metabolism, researchers looked at consuming calories later in the day and how it affects obesity and metabolic syndrome. They hypothesized that eating a late dinner alters substrate metabolism during sleep in a manner that promotes obesity. This was a randomized crossover trial of late dinner versus routine dinner with a fixed sleep period in a laboratory setting, To examine the impact of late dinner on nocturnal metabolism in healthy volunteers, they took 20 healthy volunteers (10 males, 10 females), aged 26.0 ± 0.6 years, BMI 23.2 ± 0.7 kg/m2, accustomed to a bedtime between 22:00-01:00 to examine the impact of a late dinner on nocturnal metabolism. This is a randomized crossover trial of late dinner (LD, 22:00) versus routine dinner (RD, 18:00), with a fixed sleep period (23:00-07:00) in a laboratory setting. An isocaloric macronutrient diet was administered on both visits. Dinner (35% daily kcal, 50% carbohydrate, 35% fat) with an oral lipid tracer palmitate, 15 mg/kg) was given at 18:00 on RD and 22:00 on LD. Nocturnal and next-morning hourly plasma glucose, insulin, triglycerides, free fatty acids (FFAs), cortisol, dietary fatty acid oxidation, and overnight polysomnography were measured. The results showed that LD caused a 4-hour shift in the postprandial period, overlapping with the sleep phase. Independent of this shift, the postprandial period following LD was characterized by higher glucose, a triglyceride peak delay, and lower FFA and dietary fatty acid oxidation. LD did not affect sleep architecture but increased plasma cortisol. These metabolic changes were most pronounced in habitual earlier sleepers determined by actigraphy monitoring. It was concluded that LD induces nocturnal glucose intolerance, and reduces fatty acid oxidation and mobilization, particularly in earlier sleepers. These effects can promote obesity if they recur chronically. The Journal of Clinical Endocrinology & Metabolism

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

David Clarke, PharmD Candidate, University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences

Sameen Khan, Pharm.D. Candidate, USF College of Pharmacy  

Maya Palmer, PharmD. Candidate, Florida A&M University College of Pharmacy

Jacob Roberts, PharmD Candidate 2021 of University of Colorado Denver Skaggs School of Pharmacy and Pharmaceutical Sciences 

Stephen Rubano, PharmD. Candidate, USF Taneja College of Pharmacy 

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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