October 17, 2017 : DCMS #367

DISASTERS AVERTED — Near Miss Case Studies

How to Be More Culturally Sensitive

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Osama Hamdy Part 3, Osama Hamdy Part 3, Ramadan Fasting with Diabetes

HOMERUN SLIDES — Great Clinical Presentation Highlights

Albuminuria: A Lot More Than Just a Little Protein in the Urine Part 9

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #95: Metabolomics: Applications in Type 2 Diabetes Mellitus and Insulin Resistance Part 1

MOST POPULAR ARTICLES OF THE MONTH

#1 Type 1 Cured in Mice
#2 The Effects Of Dietary Carbohydrate Restriction On Glucose-Lowering Effect In T2DM
#3 Carbohydrate Timing Affects Glucose and Insulin Excursions

There was a time when diabetes was defined as a simple lack of insulin, and when 14 year old Leonard Thompson received the first injection of insulin as a treatment for type 1 diabetes in Toronto, Ontario, on January 11, 1922,  supposedly the cure was found. We know almost 100 years later that insulin is not the cure but only one treatment. Over the past few years we have made some great strides with SGLT-2 inhibitors, DPP-4 inhibitors and GLP-1 analogs. However, all these treatments revolve around managing glucose as the regulator.

But what about managing all of the metabolites that affect energy consumption and production? The concept of metobolomics is what we are referring to, and this week our clinical text delivers the first part of a whole new way of looking at the over 275 metabolites including tissue amino acids and their derivatives, systemic bile acids, and blood phospholipids, that affect metabolic homeostasis and ultimately glucose control.
Dave Joffe

Editor-in-chief

Having worked with patients, children, adolescents, and adults who have diabetes for oh so many years, I’ve learned it’s better to change what I teach than to expect my patients to change their entire lifestyle. One of the toughest things for patients to do is to change the way they eat, especially if deep rooted in their ethnic background. One example is asking patients who are from the Middle East or those who are brought up on rice and beans to avoid or cut back on rice.

In Part 3 of this Exclusive Interview, Dr. Osama Hamdy talks with Diabetes in Control Publisher Steve Freed during the AACE 2017 convention in Austin, Texas about his type 1- and type 2-specific recommendations when fasting for Ramadan.

In this week’s Homerun Slides, testing albuminuria and potassium levels.

Type 2 diabetes mellitus (T2DM) is not simply a disorder of blood sugar control, but a condition in which multiple biochemical pathways are impacted. An illustrative example of this is the elevated blood ketone body concentration typical of T2DM, which can progress to diabetic ketoacidosis if insulin action and/or availability deteriorates.The elevations of ketone bodies and the acetone accumulation (with associated “sweet breath odor”) of severe or poorly controlled diabetes are indicative of abnormal fatty acid homeostasis and specifically, high lipolysis and hepatic beta-oxidation.

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

Recent meta-analysis conducted to address ideal amount of dietary carbohydrates in the management of T2DM.

Meal sequencing may decrease glucose levels and insulin utilization.