August 22, 2017 : DCMS #359

DISASTERS AVERTED — Near Miss Case Studies

The Power of Numbers

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Sood & Messer Part 1, Introduction and Background

HOMERUN SLIDES — Great Clinical Presentation Highlights

Albuminuria: A Lot More Than Just a Little Protein in the Urine Part 1

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #87: Measuring Insulin Action In Vivo

MOST POPULAR ARTICLES OF THE MONTH

#1 Coffee Consumption and Mortality: The Final Word
#2 Type 1 Cured in Mice
#3 Even More Protection for the Kidneys With An SGLT-2 Inhibitor (And a comment from George Bakris, MD)

Too often when we see patients we arbitrarily give them a goal A1c. Most of us don’t make every person strive for 5.7, but we sometimes forget to find out what the patient really thinks they can accomplish. This week we combined information from Dr. Karl Nadolsky and our Medical Editor to share a great example of why you need to include your patient in the decision. Check out this week’s Disaster Averted to see what I am talking about.

Dave Joffe

Editor-in-chief

A disaster can be considered many different things to different people. For some it could mean developing type 2 diabetes rather than preventing or delaying it.

If you watch our expert video series you will hear our Publisher ask many of our experts, “Whether or not you have diabetes, what would you like your A1C to be?” As our expert, Dr. Karl Nadolsky said, he’d like his to be in the normal range, ~ 5%. This is not unusual for us as health care providers to want and work towards a normal A1C, that is, depending on age, and risk for complications of hypoglycemia.

Dr. Minisha Sood is an endocrinologist, assistant professor at Hofstra School of Medicine and a 2017 recipient of the Castle Connolly Exceptional Women in Medicine Award. Her areas of expertise include diabetes, thyroid disorders, obesity, and polycystic ovary syndrome. Also the 2017 recipient of the Castle Connolly Exceptional Women in Medicine Award, Dr. Caroline Messer is a clinical assistant professor at the Mount Sinai School of Medicine and an assistant professor at Hofstra School of Medicine. Dr. Messer is actively engaged in clinical research and is a frequent guest lecturer to other physicians on topics such as thyroid disease, osteoporosis, polycystic ovary syndrome, and diabetes.

In this week’s Homerun Slides, Dr. Claude Lardinois focuses on the importance of albuminuria as it relates to chronic kidney disease in people with type 2 diabetes.

The wonders of lactate: Very recently, our laboratory has made a major improvement in the use of the minimal model to assess insulin sensitivity and evaluate its importance in metabolic control. During the FSIGT, as it is practiced, there is initially a large increase in glucose concentration, due to the glucose injection, there is an endogenous finite insulin response in normal individuals, and the insulin is then increased again at 20 min after the exogenous insulin injection. We considered the question of the fate of the injected glucose before the secondary insulin injection. In the absence of a large increase in insulin, much of the glucose is disposed by an insulin-independent mechanism, a process we termed “glucose effectiveness.”

Antioxidants and other polyphenols present in coffee confer healthy benefits to the body, which may include lowering insulin resistance, inflammation and biomarkers of liver function.

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

New data from the EMPA-REG-OUTCOME study provide more evidence of the renoprotective effects of empagliflozin in patients with type 2 and cardiovascular disease.