Do you feel that with our new president, changes to the Affordable Care Act will be: 1. Negative 2. Positive 3. Unsure Follow the link to share your opinion and see what your colleagues think!

Laurie Klipfel, RN, MSN, BC-ANP, CDE was recently asked if she could offer any pearls of wisdom for another Disaster Averted regarding a patient with type 1 diabetes who couldn't afford his analog insulin. After reading her advice, keep reading to learn how you can take action to help make insulin more affordable.

Secretion of incretin hormones: The mucosa of the intestinal tract harbors a large number of endocrine cells that give rise to various peptide hormones. These include cholecystokinin, motilin, secretin, gastrin, gastric inhibitory polypeptide (GIP, also referred to as glucose-dependent insulinotropic polypeptide), glucagon-like peptide 1 (GLP-1), glucagon-like peptide 2, and peptide YY.

Why do you respond to DIC survey questions? 1. Because the question is interesting 2. Want to share my opinion 3. Want to see what my colleagues think 4. All of the above 5. I usually don't respond

In my experience, most people will check their fasting glucose levels, but due to time, place, not enough strips, or just the fact they don’t want to see…many will not check after eating. For those who will only check once a day, I recommend alternating a fasting blood glucose check with a bedtime blood glucose check.

The incretin effect in health: The idea that gastrointestinal factors contribute to the control of postprandial glucose regulation dates back to the beginning of the twentieth century, when Moore and colleagues reported reductions in glucosuria after the oral administration of gut extracts xin patients with juvenile diabetes. Even though it is questionable whether these glucose-lowering effects were really attributable to the incretin activity of the extract (which is unlikely, because most gastrointestinal peptide hormones are inactivated by the gastric acid), this report can be considered as the first description of an incretin-like effect.

Which treatment do you feel most comfortable with for type 2 patients? 1. DPP-4 2. GLP-1 3. SGLT-2 4. Sulfonylurea 5. TZD 6. Insulin Follow the link to share your opinion and see what your colleagues think!

Male, 21 years of age has class III obesity, binge eating disorder, fatty liver, and asthma, and was recently diagnosed with type 2 diabetes. It is his freshman year at a college away from home. He eats in the cafeteria, and has no refrigerator or stove in his room. He visits today after not taking metformin or GLP-1 agonist since at starting school. He is under a lot of stress and states the food at school is terrible, unhealthy, and not diabetes-friendly at all. Note, he has been taught a lower carb meal plan. He says he is not taking Glucophage or Victoza; each of them at low doses gives him terrible diarrhea. He states he checks his glucose twice a week, with fastings in the 90-100 range. He is up 10 pounds since our last visit in September.

Glucagon and diabetes: Plasma levels of glucagon have been found to be increased in all experimental and clinical forms of diabetes mellitus. This disturbance undoubtedly contributes to the hyperglycemia of the disease and excessive ketogenesis of diabetic coma. Numerous studies have shown that failure of glucagon suppression contributes to postprandial hyperglycemia in type 1 and type 2 diabetes.

There has been a controversy over the last 30 years as to which is the best diet to prevent diabetes.