November 9, 2015 : DCMS #266

DISASTERS AVERTED — Near Miss Case Studies

Know Your Pen Needles

HOMERUN SLIDES — Great Clinical Presentation Highlights

The Present and Future of Insulin Therapy Part 15

CLINICAL GEMS — The Best from Diabetes Texts

Practical Diabetes Care, 3rd Ed., Excerpt #37: Psychological Aspects of Diabetes Part 1 of 4

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dr. Larry Hirsch, Part 2: BD Investigation Into Infusion Sets

MOST POPULAR ARTICLES OF THE MONTH

#1 With Injection Techniques, Seeing is Teaching
#2 To Use or Not to Use SGLT-2 Inhibitors 
#3 Study Suggests Caution Needed When Using Premixed Insulin in the Hospital

When we have insulin-using diabetes patients, we sometimes fall into the trap of thinking the patient knows as much as we do and has become an expert in their own care. This usually leads to problems that appear to be severe, but can be broken down into simple solutions. With this thinking in mind, we have created an entire issue to help you overcome these simple, but difficult problems.

Our Clinical Text looks at the psychological aspects of diabetes and delves into some of the patient-directed actions that become problems, and why the daily burden of diabetes often leads our patients astray. Our Disaster Averted visits the oft quoted problem of improper pen needle use, and in this week’s Exclusive Interview, Steve Freed sits down with Dr. Larry Hirsch to discuss the results of his investigation into infusion sets, and how patients lose control even with the best technology.

Your partner in diabetes care,
Dave Joffe
Editor-in-chief

In a follow-up visit for an insulin-requiring patient with type 2 DM, it was obvious that the management of his DM had deteriorated. According to his girlfriend, this patient ate only 1-2 meals a day, but they tended to be high-carbohydrate meals. We reviewed the patient’s insulin regimem in detail and ascertained that he was using the sliding scale correctly.

In this week’s Homerun Slides, the study and results of the addition of insulin detemir to Liraglutide treatment of type 2 diabetes.

That there is a close link between long-term conditions and psychological functioning is to state the obvious. But the complexity of the relationship, especially in a condition that spans a lifetime, such as diabetes, has only relatively recently been explored.

Diabetes in Control publisher Steve Freed met with Dr. Larry Hirsch, Vice PresidLarry Hirschent of Global Medical Affairs for the Diabetes Care Business at BD at the 2015 ADA Sessions in Boston. This week, Dr. Hirsch shares the results of his investigation into infusion sets, the “achilles heel of pumps,” which have rarely been the focus of past research. BD is working toward an innovative change to this common technology.

I asked a patient with erratic glucose levels where he usually gave his insulin injections to which he responded, “In my arms.” I asked, “Could you show me where?” The patient promptly rolled up his sleeves and pointed to the vein in his antecubital space.

Diabetes experts conclude diabetes treatment should continue with no changes in current recommendations.

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