July 4, 2017 : DCMS #352

DISASTERS AVERTED — Near Miss Case Studies

Patient’s Careful Documentation Saves Her Time and Money in the ER

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Dr. Ahmad Yehya: The Benefits of Bariatric Surgery

View Video | Read Transcript

HOMERUN SLIDES — Great Clinical Presentation Highlights

A Unifying Pathophysiologic Approach to The Complications of Diabetes in the Context of the Beta-cell Classification of Diabetes Part 1

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #81: Insulin actions in vivo: glucose metabolism Part 7 of 9

MOST POPULAR ARTICLES OF THE MONTH

#1 Type 1 Cured in Mice
#2 What is the Most Ineffective Medication?
#3 New ADA 2017 Standards of Medical Care in Diabetes

As we come to celebrate our nation’s birthday, there are a lot of issues that need to be solved: healthcare coverage, defense issues, trade policies, and the like. One good thing is that gas prices are at an all-time low, and so many more people are expected to be traveling. When most people travel it is simple: load up the car, fill up the tank and take off — but when you have diabetes it is not so easy. This week we have a plan for vacationing patients to use to save time and money if something goes wrong.

Dave Joffe

Editor-in-chief

One of my patients had a serious head injury from a fall which resulted in an unconscious period of time when on vacation. She spent five days in a hospital neuro unit during recovery. She had a list of all her medications, medical history (brief), and latest lab work including liver function with her. She also …

In this Exclusive Interview, Dr. Yehya explains the benefits of bariatric surgery in specific patient populations.

In this week’s Homerun Slides, an extension of the discussion of the beta-cell classification of diabetes.

Cellular, biochemical, and molecular mechanisms of insulin action: The insulin receptor is a glycoprotein consisting of two alpha subunits and two beta subunits linked by disulfide bonds and expresses insulin-stimulated kinase activity directed towards its own tyrosine residues. Insulin receptor phosphorylation of the α subunit, with subsequent activation of insulin receptor tyrosine kinase, represents the first step in the action of insulin on glucose metabolism.

Ralph DeFronzo and his researchers at UT Health at San Antonio announced that they have cured type 1 diabetes.

As we know, the most ineffective medication is the one needed but never taken. There are many reasons our patients don’t take prescription medicines, but a biggy is the cost. If a medicine is too expensive, the patient will not fill the prescription, therefore won’t take it. For example, when ordering an SGLT-2 and/or GLP-1, each can cost hundreds or more for a month’s prescription. Some are covered for both. Some are covered for one brand, but not the other.

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