Letter from the Editor #699:

When you look up alpha-1 antitrypsin you find out that it is a protease inhibitor belonging to the serpin superfamily, and a deficiency leads to a condition in which the body does not make enough of a protein that protects the lungs and liver from damage. This condition can lead to emphysema and liver disease, but what does it have to do with diabetes? This week in an exclusive interview our publisher, Steve Freed, had a chance to speak with Dr. Eli Lewis from the Department of Clinical Biochemistry and Pharmacology, Ben-Gurion University of the Negev, about how the study of alpha-1 antitrypsin could lead to a cure for type 1 diabetes, and how his research with pig islet cells may change the face of type 1 forever.

This week the ADA issued new guidelines on nutrition which are more directed at getting rid of the "one size fits all" approach to nutrition and personalizing diet plans for patients. They mentioned the idea of appropriate portion sizes and maintaining the pleasure of eating. One thing they don’t seem to address is the socioeconomic situations that many of our patients are in and how that affects their ability eat properly.

I am not sure how many of you have ever written a prescription for the new medication Invokana. This is the first in the new class of drugs known as SGLT2 Inhibitors. This whole class is going to grow in the next five years and although most clinicians have never used it we already seeing another new class of drugs heading our way. The ‘glimins’ target key defects of type 2 diabetes by providing a unique mechanism of action that works on the pancreas, liver and muscles: check out this week’s item #12 to learn more. 

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Dave Joffe, Editor-in-chief