February 7, 2017 : DCMS #331

DISASTERS AVERTED — Near Miss Case Studies

When Patients Change Insulin Pumps, Beware! Changes May Occur

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Israel Hodish, MD, PhD: “Why Insulin Therapy Doesn’t Work”

Read Transcript   |  View Video

HOMERUN SLIDES — Great Clinical Presentation Highlights

EMPA-REG Outcome Trial, Part 8

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #61: Mechanisms of Insulin Signal Transduction Part 5 of 8

MOST POPULAR ARTICLES OF THE MONTH

#1 New ADA 2017 Standards of Medical Care in Diabetes
#2 Caution: NSAIDs with SGLT-2 Inhibitors May Cause Renal Injuries
#3 Remission of Prediabetes to Normal Glucose Tolerance in Obese Adults

Many educators and researchers have said that insulin is the best therapy for diabetes patients. When we teach patients how to dose properly, it does make logical sense that insulin indeed is the best. However, there was an interesting presentation at the ADA Scientific presentations that seemed to state the opposite. Our Publisher, Steve Freed, finally caught up with Dr. Israel Hodish to get the real story.

Dave Joffe

Editor-in-chief

Woman, 53 years of age, type 1 diabetes, has been wearing an insulin pump for 18 years. Recently changed insulin pumps. Not only upgraded on a certain brand, but now has a totally different brand. We did not change settings when she started with her new pump. She called to let me know her glucose levels were higher since she has her new pump.

In this exclusive interview from ADA Dr. Israel Hodish discusses the provocative topic “Why insulin therapy doesn’t work and what we can do about it,” with Steve Freed.

In this week’s Homerun Slides, the implications for practice and conclusion of the EMPA-REG Outcome Trial.

PI-3 kinase-independent pathways for stimulation of glucose transport: The CAP/Cbl/TC10 pathway.

Substantial evidence confirms the presence of PI-3 kinase independent pathways for stimulation of glucose transport. It had long been clear that other growth factor receptors (i.e., the platelet-derived growth factor (PDGF) receptor, cytokine receptors such as IL-4, and certain integrins) activate PI-3 kinase to the same extent as the insulin receptor with generation of PI(3,4,5)P3, yet still do not stimulate glucose transport.

Psychological health, access to care, expanded and personalized treatment options and the tracking of hypoglycemia emphasized.

New research finds issue in the setting of dehydration and/or during use of nonsteroidal anti-inflammatory agents (NSAIDs) or radiocontrast studies.

The use of a high protein diet instead of a high carbohydrate diet to help reverse the progression to diabetes.