February 23, 2016 : DCMS #281

DISASTERS AVERTED — Near Miss Case Studies

When Pills Are Hard to Swallow, Find Alternatives

HOMERUN SLIDES — Great Clinical Presentation Highlights

Diabetes for Cardiologists Part 11

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #12: Epidemiology and Geography of Type 2 Diabetes Mellitus Part 1 of 5

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

The Benefits of SGLT-2 and GLP-1s

MOST POPULAR ARTICLES OF THE MONTH

#1 Shifting Paradigm in Diabetes Treatment – An Interview with Dr. Vinik
#2 D2 – Dementia and Diabetes
#3 International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #9: Epidemiology and Risk Factors for Type 1 Diabetes Mellitus Part 3 of 5

I just spent the day in a conference talking about the genetic differences in different ethnic groups, and how that affects both causes and treatments for diseases such as cancer, congestive heart failure, and hypertension. I personally know how genetics can have an effect, because I lack the proper gene to process cilantro. Like most cilantro haters I have a defect in my olfactory-receptor gene, called OR6A2, that picks up on the smell of aldehyde chemicals.

Aldehyde chemicals are found in both cilantro and soap and to us they smell the same. These same types of defects occur in diabetes, and this week our clinical text begins to discuss the Epidemiology and Geography of Type 2 Diabetes.

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

Woman, 67 years of age, newly diagnosed with type 2 diabetes with an A1C of 7.8%. Met with PCP who prescribed metformin ER and referred patient for diabetes education. Patient made some dietary and physical activity changes at first, but upon return visit her A1C was 8.5%. She reported she did not take the metformin. “I can’t swallow big pills. The bottle said not to crush or break the tablets. They were just too big to swallow. So then I just gave up on everything.”

In this week’s Homerun Slides, targets and therapies for type 2 diabetes based on patient characteristics and A1C.

Age- and sex-specific prevalence of type 2 diabetes in different ethnic groups: Type 2 diabetes mellitus (T2DM) is now taking its place as one of the main threats to human health in the twenty-first century. In 1921, Dr Elliot Joslin was already concerned that according to his count there had been a doubling of diabetes in three decades. The impact of T2DM is increasingly felt around the world, with its prevalence rising dramatically over recent decades.

In part 3 of this Exclusive Interview, Dr. Rhinehart shares his thoughts with DIC publisher Steve Freed on the benefits of SGLT-2 and GLP-1s. What do these new medications offer when it comes to costs, side effects and staying on top of the research to help facilitate use in the right patients?

How SGLT-2 inhibitors can provide new approach over treatment centered on attaining glycemic control, intensive therapy.

Uncontrolled blood glucose seems to increase the risk of brain troubles.

The first large-scale studies of the prediction of T1DM relied upon the detection of cytoplasmic islet cell autoantibodies (ICA) assays based on indirect immunofluorescence. High titer cytoplasmic ICA is most often associated with the presence of multiple islet autoantibodies and therefore a high risk of progression to diabetes.