July 26, 2016 : DCMS #303

DISASTERS AVERTED — Near Miss Case Studies

Sometimes it Takes a Human

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Kimberly Ward Part 2, Integrating Accu-Check with Apple

HOMERUN SLIDES — Great Clinical Presentation Highlights

Beta-Cell Classification of Diabetes and the Egregious Eleven Part 2

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #34: Beta-Cell biology of insulin secretion Part 4 of 5

MOST POPULAR ARTICLES OF THE MONTH

#1 Blood-Pressure Drug Could Be A Possible Type 1 Diabetes Cure
#2 Color Matters in Managing Hypertension
#3 Will 2017 Bring Us the First Artificial Pancreas for Type 1 Diabetes?

There are various hormones, neurotransmitters, nucleotides, and fatty acids in the pancreas that affect insulin production and secretion. Sorting all these factors out, and how we might possibly affect glucose control by mimicking  some of these compounds, has opened up new avenues of treatment. GLP-1 agonists are just one example. This week in our Clinical Text we continue our explanation of how these compounds work, and how we will continue to make progress towards better control.

Dave Joffe
Editor-in-chief

63-year-old male, moderate cognitive impairment and lives alone. Patient lost a significant amount of weight, frequent symptomatic hypoglycemia, including light-headedness and dizziness, requiring lowering and stopping some of his glucose lowering medications. GLP-1 was stopped and his glucose levels were in normal range. We were very clear that he should not resume his GLP-1 until we saw him again.

In part 2 of this Exclusive Interview, Kimberly Ward explains the integration of the Accu-Check system with an Apple app and how the system’s features benefit patients and physicians alike.

In this week’s Homerun Slides, the natural history and progression of diabetes.

Gs-protein-coupled receptor: In pancreatic beta cells, various hormones, neurotransmitters, nucleotides, and fatty acids including GLP-1, glucose-dependent insulinotropic polypeptide (GIP), vasoactive intestinal polypeptide (VIP), pituitary adenylate cyclase-activating polypeptide (PACAP), adrenaline, ATP/ADP, lysophosphatidylcholine (LPC), and oleoylethanolamide (OEA) activate their specific receptors. These receptors when coupled with Gs-protein activate adenylate cyclase and increase cAMP production. These cAMP-increasing ligands potentiate both the 1st phase and 2nd phase of GIIS.

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

African American male, 63 years of age, type 2 diabetes, hypertension, strong family history of type 2 diabetes, hypertension and stroke. A1C is 6.7%. Blood pressure 160/96 HR 88, despite being on ACE-I and Beta Blocker.

System shows significant improvement in HbA1c compared to current best therapy available.