March 22, 2016 : DCMS #285

DISASTERS AVERTED — Near Miss Case Studies

The New To-Do For Travel

HOMERUN SLIDES — Great Clinical Presentation Highlights

 Diabetes and Periodontitis Part 4

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #16: Epidemiology and Geography of Type 2 Diabetes Mellitus Part 5 of 5

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dr. George Bakris Part 1, Blood Pressure Guidelines

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

For over a year now we have had one of the premier hypertensive care physicians sharing his opinions and information on the treatment of hypertension. This week, Dr. George Bakris starts a new video series on hypertensive guidelines and how best to use them for patients. These choices become more important in light of the information we have learned from the recently published SPRINT Trial.

Many of you may not know that one of the drugs used in the SPRINT trial was a combination of azilsartan medoxomil and chlorthalidone, and that in 2012 Dr. Bakris did a study that was published in the American Journal of Medicine showing the value of chlorthalidone over HCTZ in blood pressure regulation in that combination. If chlorthalidone strikes you as an older medication and less likely to be used, you might find it interesting that Hygroton (chlorthalidone) came to market in 1960 and Hydrodiuril (hydrochlorothiazide) was approved in 1959. If you want to learn more about what Dr. Bakris found out about chlorthalidone, you may want to check out this item.

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

A patient with diabetes gets her meds, prescribed by a nurse practitioner, from a national chain pharmacy in New York. She was planning travel to Hawaii. Patient did not refill her meds at home in New York before leaving for her travel in Hawaii because it was too early. Insurance would not pay until closer to the refill date. She thought she could wait until the time insurance would cover, go to a location where she was traveling and pick it up there. She’d done that during her travels in the past. It did not work in Hawaii.

In this week’s Homerun Slides, an investigation of the contribution of periodontal disease to insulin resistance.

Obesity and weight gain have consistently been shown to be the one of the strongest modifiable risk factors for diabetes. The ratio of a person’s weight in kilograms divided by the square of their height in meters called the body mass index (BMI) has been used in numerous studies as a surrogate for obesity. In a representative sample of the US population, each unit increase in BMI was associated with a 12% increased risk of T2DM. Compared to people with BMI less than 22 kg/m2 those with BMI of 25–27 kg/m2 had 2.75 times the risk of diabetes, and each kilogram increase in body weight over 10 years was associated with a 4.5% increase in diabetes risk.

In part 1 of this exclusive video, DIC publisher Steve Freed once again visits with Dr. George Bakris to discuss the many blood pressure guidelines and what they should be for adults and those with 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.