Study looks at whether intensive BP lowering can increase the risk of CKD.

According to a recent published study, HbA1c variability is a better predictor of mortality in patients with type 2 diabetes compared with HbA1c averages.

First real-world study comparing SGLT2i therapies also showed patients taking INVOKANA 300 mg significantly less likely to discontinue treatment or switch to another diabetes medicine.

High blood pressure and prediabetes together may do more harm to the body than either one alone.

Mrs. Hunter is a 36-year-old African-American who comes to your office for her annual wellness exam. She has excess weight (BMI 27 kg/m2), but is otherwise healthy. She jokes that she, “just can’t seem to lose that extra baby weight” after giving birth 3 years ago. However, her daughter recently started preschool so she has been able to go to her new gym several times per week. In fact, one of the added bonuses of her membership is that she has been participating in their free, weekly nutrition and exercise support groups. In addition to her routine labs, you order an A1C, which comes back elevated at 7.1%. This measurement is confirmed several days later. Based on Mrs. Hunter’s profile, what would a reasonable next step be? A. Encourage lifestyle modifications and start metformin with an A1C target of < 7.0%.
B. Encourage lifestyle modifications and start metformin with an A1C target of < 6.0%.
C. Encourage lifestyle modifications and do not initiate drug therapy at this time.
D. Encourage lifestyle modifications and start metformin and a sulfonylurea.
Follow the link for the answer.

What is your choice for a second drug after metformin for your type 2 patients with an A1c of 8 or above and 25 pounds overweight? DPP-4 GLP-1 SGLT-2 Insulin Other Follow the link to share your opinion.

In this week's Homerun Slides, getting blood pressure to goal and the benefits of beta blockers.

Insulin-producing beta-cells are the predominant endocrine cell type in pancreatic islets, comprising 50 – 80% of islet cells. Studies with autoptic samples, organ donor specimens, and surgical cases have found that beta-cell mass in the human pancreas may vary from 0.6 to 2.1 g, with beta-cell volume and area (relative to the pancreatic tissue) ranging from 1.1 – 2.6% and 0.6 – 1.6%, respectively.

Two of the four exciting treatment options currently being trialed could change the way the disease is treated long term.

New exciting treatment options currently being trialed could change the way the disease is treated long term.