March 7, 2017 : DCMS #335

DISASTERS AVERTED — Near Miss Case Studies

Non-Compliant No More!

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Blandine Lacroix Part 3, Motivational Interviewing

HOMERUN SLIDES — Great Clinical Presentation Highlights

Albuminuria Presentation Part 1

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #65: Regulation of Glucose Metabolism in Liver Part 1 of 11

MOST POPULAR ARTICLES OF THE MONTH

#1 Health Benefits from Intermittent Fasting
#2 The Future For Insulin Pump Companies: Who Will Survive?
#3 Caution: NSAIDs with SGLT-2 Inhibitors May Cause Renal Injuries

In order to ensure that patients who really need their opioids get them, the state of Florida now mandates that every pharmacist must have a CE on Controlled Medication Dispensing. Seven years ago, Florida dispensed 10 times the amount of opioids as the rest of the country added together. However, we no longer have that distinction and, in fact, we are now one of the hardest states to get opioids. This has caused problems for many patients who really need the medications but are refused by pharmacies who have decreased their inventory to avoid scrutiny by government agencies.

As a CE provider for this course, one of the things we have to discuss is how to determine if a patient is legitimately in need or if they are just good at persuasion. One of the best techniques for seeking the truth is a technique called motivational interviewing.

This week, our interview with Blandine Lacroix delves into how to use this method with diabetes patients. It is a great primer to help you with other patients as well.

Dave Joffe

Editor-in-chief

A patient, 48 years of age, female, type 2 diabetes and obese, was referred to me for diabetes and weight management. Her first visit was 8 a.m., after fasting for 10 hours. Her A1c was 7.4%, BMI 37, BP 164/92, HR 92. The previous hcp had recorded she was recommended a low carb diet and the following medications: Metformin, 1,000mg twice daily; Byetta 10mcg sq twice daily.

It was also written that she was non-compliant.

In part 3 of this Exclusive Interview, Blandine Lacroix talks about applying motivational interviewing in the patient/provider conversation around diabetes.

In this week’s Homerun Slides, recognizing the role of Glycocalyx in microvascular and macrovascular dysfunction.

The liver regulates nutrient supply to the entire body. Antoine Lavoisier first scientifically disputed the concept of vitalism by proving that the combustion of material in the blood formed the basis of life and mechanical work by muscle. He suggested that these nutrients were not only absorbed by digestion but that liver played an important anabolic role in maintaining life.

Fasting shown to reduce risk of diabetes, heart disease, cancer and other diseases.

As problems for Tandem continue, and with Johnson & Johnson abandoning the insulin pump market, it’s beginning to dawn on some people that we soon could live in a world with just two insulin pump companies – Medtronic and Insulet.

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