April 4, 2017 : DCMS #339

DISASTERS AVERTED — Near Miss Case Studies

Don’t Be So Disciplined!

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Michael Hill Part 2, How It Works

HOMERUN SLIDES — Great Clinical Presentation Highlights

Albuminuria Presentation Part 5,  A Look at Treatments

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #69: Regulation of Glucose Metabolism in Liver Part 5 of 11

MOST POPULAR ARTICLES OF THE MONTH

#1 A Step Closer To A Cure: Reprogramming Beta Cells
#2 Health Benefits from Intermittent Fasting
#3 The Future For Insulin Pump Companies: Who Will Survive?

For years they said there would be a “cure” for diabetes. There was INGAP therapy, beta cell transplants, Dr. Denise Faustman, and many other promising developments that were supposed to be the next big thing in diabetes. However, it seems that now we are looking to manage diabetes rather than cure it. One of the most promising methods to do this is a closed-looped system. But what is a closed-loop system, and does it do everything that people expect it to do?

Since so many people and prescribers think that you just put it on and…presto, chango, you are fixed, we felt that a real-life explanation of what a closed-loop system can actually do would be of great value to you. Our publisher, Steve Freed, sat down with Michael Hill, Vice President at Medtronic, to learn the real story of what this Intensive Insulin Management system can do for your patients.

Dave Joffe

Editor-in-chief

I don’t know how many times I have the opportunity to teach patients and health care providers that it’s not all about food. I was recently reminded of that when I overheard a dietitian, a CDE, go over a 4-week CGM report with a patient, male, 53 years of age, type 2 diabetes, non-obese, actually not even overweight.

In part 2 of this Exclusive Interview, Michael Hill explains what the hybrid closed-loop system can and can’t do as well as some of the benefits.

In this week’s Homerun Slides, successful – and unsuccessful – medications and clinical trials.

Transcriptional regulation of gluconeogenesis: The gradual shift from the fed-to-fasted state is followed closely by hormonal regulation of genes encoding PEPCK, fructose-1,6-bisphosphatase, and the glucose-6-phosphatase catalytic subunit. The transcriptional regulation of these genes remains a developing research area and its many emerging nuances cannot be completely covered here.

Type 1 beta cells succumb to autoimmunity, leaving significantly reduced beta-cell mass and lifelong dependence on insulin replacement therapy, while type 2 beta cells fail to secrete sufficient insulin to overcome prevailing insulin resistance.

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.