June 28, 2016 : DCMS #299

DISASTERS AVERTED — Near Miss Case Studies

The New To-Do For Travel

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dr. A. Paul Chous Part 3, What’s New in the Treatment of Diabetic Eye Disease

HOMERUN SLIDES — Great Clinical Presentation Highlights

Pharmacologic Management of Type 2 Diabetes Part 3

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #30: Insulin Gene Expression and Biosynthesis Part 6 of 6

MOST POPULAR ARTICLES OF THE MONTH

#1 Victoza LEADER Trial Top-Line Results Announced
#2 Blood-Pressure Drug Could Be A Possible Type 1 Diabetes Cure
#3 Misuse of New Insulin Strengths

Typically our diabetes patients have changes in vision and they totally ignore them. They blame it on age, environment, old glasses and any other excuse. We as medical professionals don’t stress the possible changes enough because we are more focused on things like neuropathy and kidney failure. This means that a lot of patients get all the way to macular degeneration before we get serious about their eyes, and then we have to try everything we can to help them.

This week, we have Part 3 of our exclusive interview from Dr. Paul Chous, as he looks at future treatments for diabetes-related eye diseases. If you did not get to see Part 1 and Part 2, then take a look.

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 part 3 of this Exclusive Interview, Dr. Chous gives a brief tour of what’s on the horizon in treating diabetic eye disease.

In this week’s Homerun Slides, the Canadian Diabetes Association lists insulin action and examples of insulin initiation and titration regimens in people with type 2.

Regulation of proinsulin conversion: PC2 and PC1/3 are Ca2+-dependent enzyme activities with an acidic pH 5 – 5.5 optimum. Fortunately, the beta granule contains an intraorganellar environment of 1 – 10 mM free Ca2+ and acidic pH 5.5, which ideally suits the requirements for optimal PC2, PC1/3 and CP-H activities within this organelle.

Victoza LEADER trial of 9,000 adults with type 2 diabetes found that drug significantly reduced the risk of heart attack or stroke.

A common blood pressure drug is showing new promise to help treat and cure type 1 diabetes.

We certainly have important education to accomplish with patients and health professionals regarding the new higher concentration insulin products that are available only in a pen, including U-300 TOUJEO (insulin glargine), U-200 TRESIBA (insulin degludec), and U-200 HUMALOG (insulin lispro). U-500 insulin is also available in a pen (HUMULIN), although vials remain on the market. Patients may not understand proper dosing and dose measurement with these higher concentrations of insulin products.