Editor’s Note, DCMS #156:

By the time that you read this newsletter we will either be in a funding gridlock or not, but regardless the Affordable Care Act will have started. A lot of attention has been on government programs but private health insurance is also affected by this new program. This week in our Homerun Slides, we cover Medicaid expansion, Shareholder impact and plan and provider penalties and rewards.

When we hear or see the terms "BMI 25-30" and "rapid acting insulin" we often think of a preset sliding scale for mealtimes and correction based on weight. However if a patient sees these terms they may have a totally different idea which could end up in disaster. Our Clinical Case looks at what we should do for a 35 year old woman who has a 10 day history of constant palpitations, weakness and irritability, and our Mastery In Minutes video may surprise with a discussion on how beta cell resistance can show up even with a normal A1c.