See the Product of the Week.

Last week in our SGLT- Inhibitor Special Edition for May, we discussed the idea of early adopters using the complete arsenal of diabetes medications for both type 1 and type 2 patients. When I mentioned that one of our advisory board members, Dr. Stanley Schwartz, sets a high bar in using …

Sometimes the early adopters receive a little scorn from their colleagues for "jumping on the bandwagon" too early. However it seems that usually sooner or later everyone else comes over to their way of thinking and the "experimental" becomes the norm. A good example of this is the use of …

We often threaten our patients with the complications of diabetes to try to get them to work on their diabetes. Kidney failure and dialysis are the most scary ones that we can talk about. But what happens when we finally have to start a patient on dialysis? This week our …

David Levy, MD, FRCP      Cataract Diabetes is a strong risk factor for cataract, and it occurs earlier and progresses faster than in the non-diabetic population. Cortical cataract is the most frequent, with its typical radial spoke opacities. Indications for cataract surgery include impairment of vision that reduces quality of life, and …

David Levy, MD, FRCP      Pre-proliferative retinopathy An important diagnosis, as there is a very high risk of progression to proliferative retinopathy and significant visual loss. Pre-proliferative changes are characterized by the following. Multiple (> 5) cotton-wool spots. Multiple large blot hemorrhages. Venous abnormalities: irregularities, beading, looping or reduplication. Intraretinal microvascular abnormalities: …

David Levy, MD, FRCP      Non-proliferative diabetic retinopathy Background retinopathy Microaneurysms Small, red, intraretinal lesions usually found at the posterior pole of the eye, around the disc and macula. They occur in areas of capillary non-perfusion and show leakage of fluorescein. It is worthwhile estimating the number of microaneurysms as it has …

David Levy, MD, FRCP      Introduction Diabetic retinopathy is the most common clinically significant microvascular complication of diabetes, but cataract is the most common ocular complication, with a prevalence of about 60% in those aged 30–54, five times more frequent than in those without diabetes. Diabetes is also associated with raised intraocular …

The patient, a woman, 52 years of age, has type 2 diabetes and is on metformin, a GLP-1 agonist, and a long-acting insulin. Over the past few months, I’ve received calls and emails from her every now and then to let me know her glucose levels were rising, but whenever …

Dr. Joe Houmard address the issue of “healthy obesity” noting that although recent data does seem to support the concept, especially for those who are overweight rather than obese, it is still preferable for patients to be at a normal weight…. Joe Houmard, Ph.D. has been at East Carolina University in …