Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.
TOP STORIES — Diabetes News and Research
The Preferred Insulin for the Elderly
Letter from the Editor
During the time that we have pharmacy interns on rotation with us, we spend time learning about diabetes and the real world effects of the disease, medications and lifestyle changes. One of the first slides we cover is the one from Stratton IM, et al. BMJ. 2000;321(7258):405-412 that describes the benefits of lowering your A1c by 1% as it pertains to cardiovascular complications and, specifically, myocardial infarction.
That information is over 20 years old, so I asked our intern, Leyany Feijoo Ramos, PharmD Candidate, LECOM School of Pharmacy, to see if she could verify that A1c lowering can reduce a patient’s risk of MI. She looked at some newer studies and found that the results were even more dramatic. She even found that patients who had fairly well controlled diabetes could also benefit from going even lower.
Check our her article on how lowering A1c levels can result in lowering MI risk in both men and women.
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We can make a difference!
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Dave Joffe
Editor-in-chief
TOP STORIES — Diabetes News and Research
Long-acting insulins seem to be the best choice for elderly patients diagnosed with type 2 diabetes.
Researchers discovered that dapagliflozin helped patients with and without diabetes in improving kidney disease.
A recent study evaluated how diabetes status, A1C, and gender influence the risk of myocardial infarction (MI).
Did You Know? Diabetes and Prediabetes Diagnosis Varies Among People of African Descent:
African descent populations in the United States have high rates of type 2 diabetes and are incorrectly represented as a single group. Current glycated hemoglobin A1c (HbA1c) cutoffs (5.7% to <6.5% for prediabetes; ≥6.5% for type 2 diabetes) may perform suboptimally in evaluating glycemic status among African descent groups. When used to diagnose diabetes or prediabetes, the A1c level performs differently among persons of African descent, depending upon their specific ethnicity, new research suggests.
A scoping review of US-based evidence documenting HbA1c performance to assess glycemic status among African American, Afro-Caribbean, and African people was done. Findings from a meta-analysis by Lakshay Khosla, B.A., and colleagues of 12 U.S. studies were published online on March 11 in Preventing Chronic Disease.
The studies evaluated the use of recommended A1c cutoff levels to diagnose diabetes and prediabetes among Americans descended from African people (African Americans), Afro-Caribbean people, and people who immigrated from Africa (Africans). Overall, the currently used cutoff levels of 6.5% or higher for diabetes and 5.7% to 6.5% for prediabetes tended to overestimate glycemia in African Americans and underestimate it in Afro-Caribbean and African people. For African people, underdiagnosis of prediabetes and type 2 diabetes is also likely at the standard HbA1c cutoffs because diagnosis was missed by HbA1c despite being detected by oral glucose tolerance test [OGTT].
From the results, it was suggested that we use both A1c and fasting plasma glucose [FPG ] or, better yet, a 2-hour oral glucose tolerance test [OGTT].
Preventing Chronic Disease – SYSTEMATIC REVIEW — Volume 18 — March 11, 2021
Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletters:
Macrina Ghali, PharmD Candidate 2021, Florida A&M University, College of Pharmacy and Pharmaceutical Sciences
Oluwatayo Ishola, PharmD. Candidate, South College, School of Pharmacy
Leyany Feijoo Ramos, PharmD. Candidate, LECOM School of Pharmacy
A’Kira Shavers, PharmD Candidate, South College School of Pharmacy
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Steve and Dave
Diabetes In Control
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