November 6, 2015 : Issue #806

• Study Suggests Caution Needed When Using Premixed Insulin in the Hospital
• Eating Disorder in Type 1 Diabetes and Factors of Insulin Limitation
• New Insight on Levothyroxine Hypothyroidism Monotherapy
• Exercise Difficulties In Older Women With Type 2 Diabetes
• Pregnant Women With Elevated Blood Sugars Are At Greater Risk of Having Children With Heart Defects
• Obese Children At Greater Risk of Developing Heart Disease and Diabetes
• FDA Warning: Invokana Can Increase Risk of Bone Fracture
• New Recommendation: Screen for Abnormal Blood Glucose in ALL Overweight Adults between 40 and 70
• Diabetes Increases Risk of Surgical Site Infections
• Reducing Sugar Improves Metabolic Syndrome Markers in Obese Children

Oftentimes when an insulin using patient is admitted to the hospital they are kept on the same insulin product and regimen they arrived with. For many patients this works well but for those using mixed insulin there appears to be an increased incidence of hypoglycemia. This could be because of multiple factors including dietary changes in the hospital and the use of bolus insulins only to correct elevated levels. If you want to know the details then be sure to check out item #1.

Metformin was approved in Japan in 1961 and Canada in 1972, but did not receive approval by the U.S. Food and Drug Administration (FDA) for type 2 diabetes until 1994, because of fears of lacticacidosis. Now it appears that the Japanese are going to jump ahead with a once a week version of a potent daily diabetes drug. Click here to see what that drug is.

Announcements:

dLifeTV.com: Sunday, November 8, 7PM ET

From dLife.com: “The story of a law enforcement veteran who faced down discrimination at the FBI…and won. Then, a rising rap star explains her struggles with her dad’s diabetes, and getting up close and personal with your pancreas.” Sundays live online at dLifeTV.com at 7 PM ET, 6 PM CT, and 4 PM PT. Keep up on the latest dLife news at dLifeTV.com.

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We can make a difference!

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Dave Joffe, Editor-in-chief

At what age should doctors be tested for competence? Follow the link to offer your opinion!

This app by G.P. Imports, Inc. is an easy way for patients to record and keep track of diabetic information.

Researchers at the Massachusetts Institute of Technology have developed a pill with hollow needles (at left) that can inject a drug directly into the stomach lining once the capsule has been swallowed and its outer coating dissolved. The approach is still in its infancy, but it could provide another way to deliver insulin.

Follow this link to download illustrated PDF handout for your patients (you must be logged in to the site to access).

The road to exercise might begin with the first step, but for people with neuropathy (nerve damage), foot complications, balance issues, or lack of mobility, steps in general might be hard to take. You can still get a good workout in your chair and that’s vital, says LeeAnn Langdon, an American Council on Exercise (ACE) –certified personal trainer and senior fitness specialist. “If there is such a thing as a fountain of youth, and a fountain of health, regular, moderate exercise is it,” she says. “It’s like the best drug you don’t even have to buy.”  If you’re already an avid exerciser, these moves might not make you work up a sweat, but if you’re new to exercise or need to get back in the game, sit up straight and put on some motivational music. It’s time to do your body some good If you put all of the following moves together, you can work up to your 30 minutes of exercise per day. But if you’re not there yet or don’t have time for one longer workout, don’t fret. You can exercise in 10-minute chunks. And if you’re just starting off, start slow and listen to your body. “You should not have any pain when you’re exercising,” says Wilson. “If you go to a point of mild discomfort, then back off.” Diabetes Forecast Nov. 2015

If diabetes were a country how big would it be?

Federal Assistant Health Minister Ken Wyatt from the IDF says that “if diabetes diagnosed and undiagnosed was a country, it would be the ___th largest country in the world.”

The ten countries with the largest population in the world are China, India, United States, Indonesia, Brazil, Pakistan, Bangladesh, Nigeria, Russia and Japan.

If those with diagnosed diabetes and undiagnosed diabetes were a country, which country’s population would it be closest to? Follow the link to answer!

It is a cartridge adaptable to the mobile phone that will record whether a compound is present in saliva, which becomes visible if the patient has diabetes. It’s as simple as pregnancy tests, where the specific marker shows in a few seconds. The project is planned to be completed in two years. They wanted a device that could identify a biomarker in a sample of saliva, and it had to emit fluorescent light so a cell phone camera could record it. They also developed a micro device that can be integrated into a cell phone and where one can place a saliva sample showing the results through the software.  FEMSA Biotechnology Center

New study suggests that in hospital patients with T2DM, premixed insulin provides similar glycemic control as a basal-bolus insulin regimen.

Findings suggest that helping patients respond effectively to eating disorder symptoms might decrease insulin restriction.

Studies suggest therapy insufficient for treatment of hypothyroidism.

T2 patients had higher lactate levels and score higher on Rating of Perceived Exertion scale.

Higher glucose levels associated with odds of tetralogy of Fallot and serum glucose.

According to a new study, taking vitamin D supplements can improve exercise performance and lower the risk of CVD.  Previous studies suggest that vitamin D can block the action of enzyme 11-βHSD1, which is needed to make the stress hormone cortisol. High levels of cortisol may raise blood pressure by restricting arteries, narrowing blood vessels and stimulating the kidneys to retain water. As vitamin D may reduce circulating levels of cortisol, it could theoretically improve exercise performance and lower cardiovascular risk factors. In this study, researchers from Queen Margaret University in Edinburgh gave 13 healthy adults matched by age and weight 50μg of vitamin D per day or a placebo over a period of two weeks. Adults supplementing with vitamin D had lower blood pressure compared to those given a placebo, as well as having lower levels of cortisol in their urine. A fitness test found that the group taking vitamin D could cycle 6.5km in 20 minutes, compared to just 5km at the start of the experiment. Despite cycling 30% further in the same time, the group taking vitamin D supplements also showed lower signs of physical exertion. Presented at the Society for Endocrinology annual conference in Edinburgh, Oct. 2015.

Severity of obesity associated with higher value of low HDL cholesterol level, high blood pressure and hemoglobin A1C levels.

Bone mineral density at hip and lower spine may also decrease.

This is an update from a 2008 recommendation that only mentioned hypertension.

A meta-analysis reveals that the risk is present for most surgeries.

Benefits seen after nine days despite lack of weight loss.

Danish researchers found patients with poorly controlled type 1 diabetes had a nonsignificant -0.6% decrease in A1C levels from baseline to 12 weeks after adding once-daily liraglutide 1.2 mg to insulin, compared to -0.5% among those with a placebo add-on. The findings based on 40 diabetes patients with a body mass index of 18 to 28 and ages 18 to 70, also showed 90% of those on liraglutide and 65% of those on placebo experienced adverse events, most of which were gastrointestinal. Diabetes Care, Nov. 2015

Diabetes Thought to Increase Risk for Hepatic Cancer

Oral med approved by the Japanese Pharmaceuticals and Medical Devices Agency (PDMA) for type 2 treatment.

Quote of the Week!

“Never go to a doctor whose office plants have died.”

…Erma Bombeck

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletter:

Janice Li, LECOM College of Pharmacy
Jaydeep Patel, USF College of Pharmacy
Shawn Vahabzadeh, USF College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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