April 2, 2019 : DCMS #443

DISASTERS AVERTED — Near Miss Case Studies

Whose Responsibility is this ARB Issue?

TOP STORIES — Diabetes News and Research

Insulin Dose, Cardiovascular Disease Risk and Outcomes

When Should Basal Insulin Therapy Be Intensified In Patients With Unmanaged Type 2 Diabetes?

Glycemic Threshold Differs By Ethnicity For Development Of Diabetic Retinopathy

EXCLUSIVE INTERVIEW — Candid Video Interviews with Top Practitioners

Nancy D’Hondt on Diabetes Education

MOST POPULAR ARTICLES OF THE MONTH

#1 Aiming for an Ideal Exercise Blood Glucose
#2 Carbs Content Alone Not Enough for Insulin Calculations
#3 Effects of Metformin Go Beyond the Treatment of Type 2 Diabetes

This week our medical editor, Joy Pape, was faced with patient questions on the contaminated ARB’s, that many of you have also gotten. She had been on the front side of the valsartan problem and was changing her patients to losartan, only to have to call them back. Check out her Disaster Averted to find out what her solution was and what you can tell your patients. 

Dave Joffe

Editor-in-chief

This may not be an actual “physical” disaster averted yet because we don’t know the long-term effects on the people who have taken the ARBs and possibly other medications that were tainted with carcinogens or other “poisons.” When we (health care providers) were first notified of this issue, my first question was: “Who is responsible?” …

Intensive diabetes therapy can be associated with excess weight gain, central obesity, and dyslipidemia with increased heart disease risk.

Addition of bolus insulin to avoid overbasalization is key.

Specific A1c, glucose ranges associated with diabetes-specific vision impairment.

Nancy J. D’Hondt  RPh, CDE, FAADE is a past president of the American Association of Diabetes Educators. She is a staff/clinical pharmacist in a 600-bed facility and is responsible for the review and processing of medication orders, patient-controlled analgesia, ADR and DUR monitoring, pharmacokinetic dosing, anticoagulation, and multidisciplinary rounds. Nancy specializes in diabetes care and self-management support for both the inpatient and outpatient populations, providing expertise on protocol development and implementation, staff education, and formulary decisions.

By Sheri R. Colberg, PhD, FACSM

There is no official ideal blood glucose range to start with and maintain during physical activity, but we do know that being too low negatively impacts performance, as does being too high. As for what blood glucose target or range most athletes aim for, it depends on a number of factors, including the type, intensity, and duration of their activity. A consensus statement about exercise and type 1 diabetes published in The Lancet in 2017 suggested that a reasonable target for most people doing aerobic exercise lasting up to an hour is 126 to 180 mg/dL (7.0 to 10.0 mmol/L), only aiming higher for added protection against lows in some situations.

New evidence suggests added consideration of the protein and fat.

Metformin proposes therapeutic benefit for HFpEF treatment.