August 29, 2017 : DCMS #360

DISASTERS AVERTED — Near Miss Case Studies

Create Safe Environment for Your Patients to Tell You the Truth

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Sood & Messer Part 2, Advantages of Having a Private Practice

HOMERUN SLIDES — Great Clinical Presentation Highlights

Albuminuria: A Lot More Than Just a Little Protein in the Urine Part 2

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #88: 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 Nonnutritive Sweeteners Linked To Weight Gain

If you put glycocalyx in Google search, you will find a definition that includes “a glycoprotein covering that surrounds the cell membranes of some bacteria, epithelia and other cells.” This does not make much sense when you’re trying to help prevent kidney disease, but this glycoprotein has a lot to do with Albuminuria, This week our Homerun Slides look at how a little bit of protein in the urine can make a big difference, and why a “touch” of albuminuria is much more of a problem than we think.

Dave Joffe

Editor-in-chief

A teenage type 1 on an insulin pump was seen in our office for follow up. The download on her pump revealed some interesting numbers. First off, her glucose levels were out of target range and secondly her I:CHO ratio and her insulin sensitivity looked more like the numbers of a type 2 diabetic vs a type 1. Her I:CHO was 1:16 and her insulin sensitivity was 1:30. In my experience, I’m used to seeing a lower I:CHO and a higher insulin sensitivity in type 1 vs type 2.

Drs. Sood and Messer discuss the takeaways from their presentation with Diabetes in Control Publisher Steve Freed during the AACE 2017 convention in Austin, Texas. They also share the advantages of working for a large organization versus private practice.

In this week’s Homerun Slides, schema of the action of the Glycocalyx.

Insulin sensitivity based upon the OGTT: The previous discussion suggests that “quick and dirty” indices from fasting values may not be accurate, and it is often true that laboratory procedures are impractical. Recently, it has been suggested that indices calculated from the OGTT may be useful for population studies. For decades the OGTT has been used as a screening test and a diagnostic tool for diabetes and IGT. It might be ideal if one could classify the state of carbohydrate tolerance and simultaneously measure insulin sensitivity and beta-cell function.

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.

Artificial sweeteners may offer short-term weight loss, but at what cost?