April 10, 2018 : DCMS #392

DISASTERS AVERTED — Near Miss Case Studies

Misuse of Insulin Strengths

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Swapnil N. Rajpathak Part 4, ADA 2017 And Real World Study Guidelines

HOMERUN SLIDES — Great Clinical Presentation Highlights

Hypertension Update 2018 Part 5

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #120: The Insulin Resistance Syndrome Part 1

MOST POPULAR ARTICLES OF THE MONTH

#1 How Many Types of Diabetes Are There? Two? Five? Or Eleven?
#2 A Summary of ADA’s New 2018 Standards of Medical Care in Diabetes
#3 American College of Physicians Recommending Controversial Increase in A1c of 7% to 8%

When we talk to patients about prediabetes, one of the topics of discussion is likely to be about insulin resistance. However, what we are usually describing is glucose resistance. The lecture usually goes something like this: “If you eat too much sugar, then your cells get filled with the sugar and then the insulin can’t move any more glucose in the cells and you become resistant to insulin.”

Although there is some truth to this explanation, there are many more definitions and consequences associated with insulin resistance. This week, our Clinical Text delves into the real complexities of insulin resistance.

Dave Joffe

Editor-in-chief

We certainly have important education to accomplish with patients and health professionals regarding the new higher concentration insulin products that are available only in a pen, including U-300 TOUJEO (insulin glargine), U-200 TRESIBA (insulin degludec), and U-200 HUMALOG (insulin lispro). U-500 insulin is also available in a pen (HUMULIN), although vials remain on the market. Patients may not understand proper dosing and dose measurement with these higher concentrations of insulin products.

In part 4 of this Exclusive Interview, Dr. Swapnil N. Rajpathak talks with Diabetes in Control Publisher Steve Freed during the ADA 2017 Scientific Sessions in San Diego, CA about his interest in the comparative analysis of various drug classes and their real-world implications.

In this week’s Homerun Slides, understanding the relationship between diabetes and hypertension.

What is insulin resistance? Broadly, insulin resistance can be defined as an abnormal biologic response to insulin; insulin, whether endogenous or exogenous in origin, has limited ability to reverse a hyperglycemic metabolic state.Thus a person with insulin resistance is, almost inevitably, progressing towards developing frank type 2 diabetes (T2DM) if an intervention (usually lifestyle) is not implemented. Due to the very close link between diabetes and insulin resistance, no formal clinical definition of insulin resistance has emerged.We will discuss the potential clinical use of the insulin resistance syndrome and the metabolic syndrome later in the chapter. For now, we focus on investigation of insulin resistance as a useful entity for research concepts, and in particular discuss its biologic consequences by describing its associated risk factor perturbations.

More specific classifications for the disease could lead to more personalized treatments in the future. Is it time?

Comprehensive recommendations feature notable new recommendations for people with cardiovascular disease and diabetes.

Organization says adults with type 2 diabetes can aim for an easier-to-achieve blood sugar target than what’s been used to guide treatment in the past.