December 5, 2015 : Issue #810

• Equations Developed to Determine Blindness, Limb Amputation Risks
• Nordic Food Associated with Lowering Risk of Type 2 Diabetes
• Breastfeeding after Gestational Diabetes Mellitus
• Sildenafil Possible Treatment For Prediabetes
• Pleiotropic Effects of Metformin To Be Studied
• Guest Writer: Dr. Avni Mahiji Helps Diabetics Circumvent Holiday Health Hazards

21, 28, 30, 90. What do these numbers mean? For many of us they are the number of days before leftover insulin has to be thrown away. As a pharmacist it often amazes me what patients think they should do. If you need the quick answer for your patients be sure to check out this week’s tool.

This is the time of year when many patients succumb to holiday food. In addition, the extra activities around the season can wreak havoc with normal exercise and activity. With that in mind, we are happy to have Dr. Avni Mahiji join us to explain how best to avoid these hazards.

Announcements:

Free CME Courses
Our web site CME resource is back online! Be sure to check out the new CME courses posted there. Courses are currently available on topics including: Advances in the Medical & Surgical Management of Obesity; Diabetic Retinopathy; Strategies to Improve Prevention and Treatment of Diabetes; and more!

dLifeTV.com: Sunday, November 29, 7PM ET

From dLife.com: “dLife visits Haiti on the two-year anniversary of the devastating earthquake that continues to make diabetes a daily struggle.” 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

OmniPod Insulin Management System by Insulet: There are reported cases of needle mechanism deployment failure or delay.  The affected Pod lots have resulted in 66 medical device reports, of which three required medical intervention. See the Press Release for a listing of affected product lots.

FDA Adds New Warnings on SGLT2 Inhibitors: Calls attention to ketoacidosis, UTI risks.  The FDA said Friday that SGLT2 (sodium-glucose cotransporter-2) inhibitors such as empagliflozin (Jardiance), dapagliflozin (Farxiga), and canagliflozin (Invokana) will need new warnings on the risks of ketoacidosis, urinary tract infections, and other serious illnesses.  More than 70 cases of ketoacidosis have been reported to the agency, as well as 19 “life-threatening” cases of urosepsis and pyelonephritis, according to an FDA drug safety communication.

In your practice, are you seeing more or less patients with prediabetes and diabetes? Follow the link to respond.

Learn how long you can keep your insulin at room temperature, how long your insulin pen is good for, and when you should not use your insulin. Download 2016 Stability of Insulin Chart.

A 51-year-old patient returns to your office for a follow-up visit. She is currently taking metformin and glipizide after being diagnosed with type 2 diabetes eight years ago. She shows you her self-care logs that indicate she has been eating a healthy diet and walking daily. She has been maintaining her weight (BMI 26kg/m2). Despite her excellent efforts, her A1C is 7.8%, above her target of A1C<7.0%. When you start to discuss adding a basal insulin dose to her regimen, she bursts into tears. All of the following are common barriers to insulin therapy initiations EXCEPT (follow the link to answer):

The number of new cases of diabetes in the U.S. declined to 1.4 million in 2014 from 1.7 million in 2008, according to a report from the CDC. The report stated that an improvement in healthy eating habits, a decline in the amount of soda consumption since the late 1990s and a decrease in the average number of daily calories consumed by adults and children, as well as an increase in physical activity and the flattened rates of obesity, may have contributed to the decline in new diabetes cases.  The rate of new cases fell by about a fifth from 2008 to 2014, according to researchers at the CDC, the first sustained decline since the disease started to explode in this country about 25 years ago. The drop has been gradual and for a number of years was not big enough to be statistically meaningful. But new data for 2014 released this week serves as a robust confirmation that the decline is real. CDC Dec 1, 2015

Diabetes patients tend to overestimate complications risk, treatment benefits.

Diet containing foods high in antioxidants found to reduce risk of stroke.

Longer duration of breastfeeding showed correlation with reduction of type 2 risk.

Treatment improves insulin sensitivity, lowers risk of heart and kidney disease.

Evidence shows cardio-protective ability beyond glucose-lowering mechanism of action.

How does one address holiday temptation without going overboard health-wise?

Quote of the Week!

“I am dying with the help of too many physicians.”

….Alexander the Great

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

Janice W. Li,  PharmD intern

Jimmy Tran, PharmD Intern

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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