March 15, 2016 : DCMS #284

DISASTERS AVERTED — Near Miss Case Studies

 Diabetic Foot Calluses: Protective or Problematic?

HOMERUN SLIDES — Great Clinical Presentation Highlights

 Diabetes and Periodontitis Part 3

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #15: Epidemiology and Geography of Type 2 Diabetes Mellitus Part 4 of 5

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

 The Risks Vs. Benefits When Setting A1C Targets

MOST POPULAR ARTICLES OF THE MONTH

#1 Factors Impacting Diabetes Remission and Glycemic Control Following Bariatric Surgery
#2 The Importance of Diabetes Self-Management Education
#3 Don’t Look, Don’t Know

Sunday night I got a call from a good friend and colleague who I have worked with for the past 20 years. She is in the managed markets division of a small pharma company, and she let me know that her 21 y/o nephew had just come back from spring break in the Dominican Republic and ended up in the hospital with an 1100 glucose level. When they checked his A1c it was 9.0, and it was determined that he had developed type one diabetes.

Her first request was “I need a great Endo in Raleigh, NC” (if you know one please message me at editor@diabetesincontrol.com), and her second one was “How soon can we get him on a pump and get his A1c below 5.7?”  I explained that often we don’t treat patients to perfection when they are first diagnosed, and there are many reasons for this.

We oftentimes try to make all patients fit into the guidelines, but as our Homerun Slides show, patient goals should be individualized for every patient.

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

Calluses protect the body because, without that layer of thickened skin, pressure or friction could cause an open wound. However, in patients with peripheral neuropathy and diabetes, calluses may be covering up a much deeper wound or ulceration.

In this week’s Homerun Slides, understanding C-Reactive proteins and the conditions associated with increased and decreased CRP.

Type 2 diabetes was historically a rare occurrence in children but recent studies have reported marked increases in the prevalence of T2DM in children. Type 2 diabetes was first reported in a population-based study in 1979 of American Indian children in Arizona. This American Indian community has one of the highest rates of T2DM in adults and obesity in both adults and children.

In the conclusion of this Exclusive Interview, Dr. Rhinehart explains the necessity of taking the care of individuals into consideration when setting general health guidelines for the management of diabetes.

Study finds remission rates of diabetes in patients who undergo weight loss procedure.

In part 4 of this Exclusive Interview, DIC publisher Steve Freed asks Dr. Andy Rhinehart, “How would you improve the care of a patient going to a family practitioner with type 2 diabetes?”

Woman, 55 years of age, type 2 diabetes for 15 years. When first diagnosed, did all she could to learn everything about managing her diabetes. She even went to two complete diabetes education courses. The second she paid for on her own. In time, she started checking less, ate more and more unfriendly diabetes foods, and due to a chronic ankle problem, became more and more inactive. After losing her insurance, she then stopped taking her medications and checking her glucose, until she noticed bloody drainage on her clothes from rashes several places on her body.