December 2, 2015 : DCMS #269

DISASTERS AVERTED — Near Miss Case Studies

Sometimes Long-term Patient/Healthcare Provider Relationship Must Be Severed

HOMERUN SLIDES — Great Clinical Presentation Highlights

The Present and Future of Insulin Therapy Part 18

CLINICAL GEMS — The Best from Diabetes Texts

Practical Diabetes Care, 3rd Ed., Excerpt #40: Psychological Aspects of Diabetes Part 4 of 4

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dr. Richard Bergman, Part 1 – Measuring Insulin Resistance

MOST POPULAR ARTICLES OF THE MONTH

#1 With Injection Techniques, Seeing is Teaching
#2 Ingenuities, Advancements, and Future Endeavors in the Treatment of Diabetes
#3 The Present and Future of Insulin Therapy Part 14

When we talk about the causes of diabetes we know it is not just one thing; in fact the Ominous Octet is a phrase that is often used to describe the defects that play a role in diabetes. The first and most well-known of these is insulin resistance. In fact the most often-used slide in all of diabetes is the one from The International Diabetes Center showing the progression of insulin resistance.

Our publisher, Steve Freed, sat down with Dr. Richard Bergman, the researcher who developed and shared that slide at the 75th ADA Scientific Sessions, to get him to share how he came up with this concept and how he used his engineering background to develop the concept of insulin resistance.

While we are on the subject to of insulin resistance you will want to review our homerun slides to see how the use of a SGLT-2 inhibitor can actually decrease this resistance.

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

I am a primary care provider in a small private office. A long-term patient of mine, 32 years of age, was recently diagnosed with type 1 diabetes. His insurance is now one I do not participate in. Until his recent diagnosis, he visited annually and paid out of pocket. He wanted to stay with me for his care….

In this week’s Homerun Slides, the effect of dapagliflozin on endogenous glucose production, plasma insulin and glucagon concentration.

In the Look AHEAD study, about 15% had symptoms of mild–moderate depression, about 17% were current users of antidepressant medication, and about 4% both [13]. Other studies in the USA have described higher rates, up to 25%, of more severe depression, with all ethnic groups (white, African-American, Latinos and others) recording similar rates.

Diabetes in Control Publisher Steve Freed meets with Dr. Richard Bergman at the 75th ADA Scientific Sessions in Boston. In this first installment, Dr. Bergman shares his start in diabetes research and explains the high points of his presentation, Comparative Methods for Assessment of Insulin Sensitivity: Oral Vs. Intravenous. Dr. Richard Bergman is the founder and director of Diabetes and Obesity Research Institute, Biomedical Sciences at Cedars-Sinai in Los Angeles. He introduced the use of engineering principles to understand the pathogenesis of diabetes.

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.

Researchers approximate that 387 million people worldwide are living with diabetes mellitus, whose prevalence will reach 10% of the world’s adult population (592 million) by 2035.

In this week’s Homerun Slides, the effectiveness of Lixisenatide when added to basal insulin, and strategies for avoiding or minimizing the GI effects of GLP-1.