June 26, 2018 : DCMS #403

DISASTERS AVERTED — Near Miss Case Studies

How Much Monitoring is Too Much?

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Scott Kahan on Obesity, Endocrinology, and Compassionate Dialogue

HOMERUN SLIDES — Great Clinical Presentation Highlights

Future Use of Technology in Outpatient Care Part 4

CLINICAL GEMS — The Best from Diabetes Texts

International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #131: Pathogenesis of Type 2 Diabetes Mellitus Part 2

MOST POPULAR ARTICLES OF THE MONTH

#1 Can’t Afford Insulin? There Are Options!
#2 Very Low Carbohydrate Diet Equals Better Diabetes Control
#3 Four Essentials In The New Trump Drug Pricing Reform Plan

Joy and Steve just returned from the ADA Scientific Sessions in Orlando, and over the next few weeks, you will have the chance to find out what they and our other reporters learned. For a little teaser, our Medical Editor, Joy Pape, shares her experiences with the recommendation and use of CGM devices. She makes an interesting case for patients with diabetes and even prediabetes to use these devices, and why even a casual observer of glucose readings could benefit from using one.

To learn more about the newest CGM’s available, check out the newsflash from last Saturday’s issue.

Dave Joffe

Editor-in-chief

What I love about going to conferences is the realization that what I’m doing in my practice is in line with what others I respect are doing. That is meaningful, and I always learn a new pearl. If that’s all I gain from these conferences, it’s okay, but it’s usually more than that.

I have just returned from the 2018 ADA Conference, where there was so much about new technology, particularly continuous glucose monitoring.

Scott Kahan, MD, MPH is the Director of the National Center for Weight and Wellness. He is a physician trained in both clinical medicine and public health. He serves on the faculties of the Johns Hopkins Bloomberg School of Public Health, the George Washington University School of Medicine, and the George Washington University School of Public Health and Health Services.

In this week’s Homerun Slides, the benefits of health and disease management programs, which can integrate evidence-based best practices into patient care.

The natural history of T2DM has been well described in multiple populations and is reviewed in references [1] and [3]. Individuals destined to develop T2DM inherit a set of genes from their parents that make their tissues resistant to insulin and the insulin resistance is aggravated by weight gain and physical inactivity. Hepatic insulin resistance is manifested by an overproduction of glucose during the basal state despite the presence of fasting hyperinsulinemia [38] and an impaired suppression of hepatic glucose production (HGP)

We all know the benefits of the newer insulins, i.e., faster action times, less peak from the long actings, etc. But the cost, more often than we know, can lead to patients decreasing insulin doses, doing without until the next payday, or doing without it altogether, as we’ve read about. (See David Kliff’s recent article.) …

Low carbs equals lower blood sugars and control, with less hypoglycemia, but how low do our patients need to go?

Administration releases “American Patient First” blueprint to lower drug prices, reduce out-of-pocket costs.