One of your patients has referred her 21-year-old stepson for a new patient exam. He has recently arrived home from college for the summer and she is concerned because he always seems to be thirsty. When prompted, she recalls her husband saying his ex-wife struggled with her weight and took “pills for her blood sugar.” Physical examination is notable for mildly elevated BP (137/84) and BMI 26 kg/m2. He denies any cigarette or alcohol use, states his favorite activities revolve around video games, and that he doesn’t really enjoy any physical activities. Labs are notable for random plasma glucose 312 mg/dl, UA positive for glucose. What would your initial drug therapy strategy be? A. Initiate monotherapy with metformin B. Initiate a combination therapy with two noninsulin agents C. Initiate lifestyle modifications D. Initiate insulin therapy Follow the link for the answer.

In this week's Homerun Slides, the technology currently and soon to be helping people to manage their diabetes.

Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of liver disease ranging from simple liver fat accumulation to severe hepatic necro-inflammation (nonalcoholic steatohepatitis or NASH), and eventually cirrhosis.

Patients with type 2 diabetes usually do not die from diabetes, but from cardiovascular disease and strokes.

Benefits of exercise shown to depend on duration, not exercise type

Study finds linoleic acid has long-term benefits in diabetes prevention, arachidonic acid not harmful.

Statin therapy may be elevating risk of type 2 diabetes in high-risk adults.

SEARCH For Diabetes In Youth Study finds more at risk of developing diabetic peripheral neuropathy than previously thought.

By Guest Writer David Kliff, Publisher, Diabetic Investor: Although it has taken much longer than I anticipated, market dynamics are forcing companies to think differently and we are now on the verge of patients being prescribed diabetes management systems rather than individual pieces of the system.

You have decided that one of your patients, a 72-year-old, should add a basal insulin dose to her antihyperglycemic regimen. During your discussion with her, she voices concern that between her “arthritic hands and poor vision” she won’t be able to accomplish this. You make the recommendation that using an insulin pen will make injection easier for her. Which of the following statements regarding insulin pens is true? A. They all require loading with an insulin cartridge. B. They have more accurate dosing than syringes. C. They can now dose insulin in .10 units increments. D. They are now available for all types of insulin. Follow the link for the answer.