Blood Glucose Control

Woman, 53 years of age, type 1 diabetes, has been wearing an insulin pump for 18 years. Recently changed insulin pumps. Not only upgraded on a certain brand, but now has a totally different brand. We did not change settings when she started with her new pump. She called to let me know her glucose levels were higher since she has her new pump.

Two studies show use of sensor implanted under skin that continuously monitors glucose levels resulted in improved levels in T1 patients who inject insulin multiple times a day.

Study shows significant improvement in diabetes control with a 1 point drop in A1c with less hypoglycemia.

Man, 51 years of age, type 1 diabetes for 32 years. Patient also has history of Class II obesity, CVA, MI and insulin resistance. Patient referred to Obesity Center for weight loss. A1c was 8.2%. Plan was to start Symlin. Symlin was added at 30mcg daily before dinner. I recommended he get a CGM. He did.

Psychological health, access to care, expanded and personalized treatment options and the tracking of hypoglycemia emphasized.

New recommendation based on results from two large clinical trials for patients with diabetes and CVD.

Clinically significant hypoglycemia redefined, bariatric surgery renamed.

by Sheri Colberg, Ph.D., FACSM
My last article focused on why glucose was the best short-term treatment for hypoglycemia, but this time I want to switch gears and talk about why treating lows is not as straight-forward as you would think. It mainly stems from the fact that sometimes hypoglycemia can be very difficult to treat effectively and even hard to prevent in many cases, particularly related to physical activity.

Yes, it’s that time of year again when your phone/email/computer is busy with patients wanting appointments and making commitments to make their New Year’s Resolutions. Often at this time of the year, my patients come in wanting to change just about everything about what they eat, when they eat, how much they eat, and the same for being physically active. So many of these patients have told me they have tried and tried and tried and failed in the past, but now it’s the New Year and it’s going to be different.

Female, 20 years of age, type 2 diabetes, is obese with anxiety disorder, untoward response to several classes of agents. Reports eating lower carbs since last seen. During the warm weather, random glucose levels and A1C were near normal. Today is a cold winter day. Random glucose 188mg/dl.