October 23, 2015 : Issue # 804

• Safety and Efficacy of the Artificial Pancreas in Type 1 Diabetes
• Granulox for Chronic Diabetic Foot Ulcers
• Bariatric Surgery Decreases Cancer Risk in Obese Women
• Impact on Physical Performance When Variations in Body Weight Occur
• Delay BP Treatment Until At-Home Measurement
• Clinical Trial Suggests Diabetes Patients May Benefit From Red Wine
• Metabolic Syndrome Impairs Vitamin E Absorption
• Glucagon Patch Meets Phase 2 Goal
• Benefits Found in Duodenal-Jejunal Bypass Surgery
• Sulfonylurea Therapy Over Insulin Benefits Neurodevelopment

Many of you were probably aware that 10/20/15 was “Back to the Future Day,” the date that Doc Brown set for Marty McFly to go to the future. There were all kinds of programs and advertisements for this day. In Saint Petersburg you could get 1 year for $20 at the Metropolitan Museum, and other cities had parties and even parades. Newscasters did stories on what has come true since then and this morning at breakfast I was taken in by a spoof in USA Today. The front page had an article about eating high cholesterol to cure cancer.  The study was conducted by giving two groups of rats either a low fat diet or a diet consisting of bacon cooked in lard. The results were so outstanding in the saturated fat group that they were going to study the same effects in french fries and hash browns.

I immediately thought it must be the low carbs and not the saturated fat. I was ready to look up the study when I noticed a picture above about a robbery and then I realized the spoof.

Check out https://www.channel3000.com/news/great-scott-usa-today-pays-tribute-with-back-to-the-future-edition/35959284 to see how I was fooled

This week we have an item about a new product for diabetic foot ulcers(see item 2). This new product called Granulox, contains purified hemoglobin and in a recent study showed improved diabetic ulcer healing in patients who had not been able to heal otherwise.

What is interesting is the name, and why they decided to choose it. When I first saw it I immediately thought of the old spray Granulex which has been around for over 35 years and is also for diabetic ulcers and wound healing. This spray contains trypsin, Balsam Peru and Castor oil and has the same indications as the Granulox.  Granulex costs about $20 for a 4 ounce spray can and the new Granulox will be considerably more. The real questions are, how many patients will get the wrong medication because of the spelling and why would the FDA let them have such closely related names?

Announcements:

There’s Still Time to Enter to Win a $100 Gift Card!

Submit your best advice on how to prevent insulin errors at home, at pharmacies, and in the hospital. Enter before November 1st for a chance to win.

dLifeTV.com: Sunday, October 25, 7PM ET

From dLife.com: “Dogs and cats get diabetes, too. A veterinarian explains how to recognize, and treat, diabetes in your pet. Plus, driving with diabetes – do you know what you need to do before you get behind the wheel. And Jim Turner admits that when it comes to his health, he just isn’t perfect.” Sundays live online at dLifeTV.com at 7 PM ET, 6 PM CT, and 4 PM PT. Keep up on the latest dLife news at dLifeTV.com.

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We can make a difference!

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Dave Joffe, Editor-in-chief

By Chayeol Jung
iOs $0.99

This program tracks seven records such as cholesterol, glucose, blood pressure, heart rate, weight, consumed calories, and carbs. In addition, I needed to control my diet. To support this function, Diet Diabetic has 4,000 food items for 80 national wide franchise restaurants. In order to track all data, such as cholesterol, glucose, heart rate, blood pressure, weight, consumed calories, and consumed carbs need to be recorded and edited for one year. For additional convenient function, calorie counter function is added for calculating needed calories depending on weight, height, age, and gender. Follow the link to see additional details and to download!

Have you ever had an error in the use of insulin with your patients? Follow the link to respond!

U.S. health regulators declined to approve a drug combination of saxagliptin and dapagliflozin as they want more clinical data.

Granulox is a topical spray that shows significant slough reduction and rapid wound healing. It contains purified hemoglobin, which has the potential to substantially speed wound healing for patients with chronic diabetic foot ulcerations. The active hemoglobin improves oxygen supply to chronic wounds by increasing the diffusion of oxygen into the wound base which accelerates rapid healing. The innovative oxygen therapy is also effective, safe, and easy-to-use. See Item #2.

The new Legal Advocacy How to Get Help Tear-off Pads, perfect for medical offices and clinics, help increase awareness of diabetes discrimination and how to get help from the American Diabetes Association by calling 1-800-DIABETES. The information on each pad (25 sheets/pad) is printed in English on one side and Spanish on the other. The pads are free, except for shipping and handling. Order your How to Get Help pads.

You have decided that one of your a 72-year-old patients should add a basal insulin dose to her antihyperglycemic regimen. During your discussion with her, she voices concern that between her “arthritic hands and poor vision” she won’t be able to accomplish this. You make the recommendation that using an insulin pen will make injection easier for her. Which of the following statement regarding insulin pens is true? Follow the link to take the quiz!

Diabetes patients who add dipeptidyl peptidase-4 (DPP-4) inhibitors to their metformin therapy have a lower risk of stroke and hypoglycemia than patients who take add-on sulfonylureas, according to a study. The research shows that, compared with add-on sulfonylureas, DPP-4 inhibitors also confer lower risks for all-cause death and major adverse cardiovascular adverse events (MACE) when used with metformin therapy in patients with type 2 diabetes.  DPP-4 inhibitors were associated with lower risks for all-cause death, stroke and hypoglycemia compared with sulfonylureas, but had no effect on heart attack risk and hospitalization for heart failure. Ou S-M, Shih C-J, Chao P-W et al., Annals of Internal Medicine Oct. 13, 2015. doi:10.7326/M15-0308

Using closed-loop system maintained better overnight glucose control.

Topical spray shows significant slough reduction and rapid wound healing.

Weight-loss surgery shown to improve quality of life.

Embracing weight loss maintenance may result in better physical performance and health outcomes.

Accuracy in patient blood pressures necessary before beginning pharmacotherapy.

New research shows suicide attempts increase substantially in morbidly obese patients in the years following bariatric surgery, when the “honeymoon” period of substantial weight loss comes to an end. They found that overall, self-harm risk increased from 2.33 events per 1,000 patients a year prior to the surgery to 3.63 per 1,000 patients after bariatric surgery ― a mean increase of approximately 50%. Notably, 93% of the self-harm events occurred in patients diagnosed as having a mental health disorder during the 5 years preceding the surgery. The study was published online October 7, 2015 in JAMA Surgery.

Moderate consumption thought to not cause liver damage.

One-third of Americans said to have increased intake requirements for vitamin E.

ZP-Glucagon Patch may help prevent severe outcomes with hypoglycemia.

Improved metabolic function and induced moderate weight loss observed.

Improvements seen in children with developmental delays associated with neonatal diabetes.

Researchers found 64% of diabetes patients experienced one or more episodes of hypoglycemia after receiving premixed human insulin twice daily, compared with 24% of patients who received a basal-bolus regimen with glargine once daily and glulisine before meals. The findings, based on 72 hospitalized patients with diabetes, showed similar glycemic control in both groups. Inpatient treatment with premixed human insulin resulted in similar glycemic control, but in significantly higher frequency of hypoglycemia compared with treatment with basal-bolus insulin regimen in hospitalized patients with diabetes. Oct. 12, 2015 in Diabetes Care.

People with the genetic variant MTNR1B may be at a greater risk.

FDA recommendation for treatment based on underlying cause considered unclear.

Quote of the Week!

“Become so wrapped up in something that you forget to be afraid.”

…Lady Bird Johnson

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletter:

Ashley Garringer, USF College of Pharmacy
Shawn Vahabzadeh, USF College of Pharmacy
Kristie Huynh, LECOM College of Pharmacy
Jaydeep Patel, USF College of Pharmacy
Yasmien  Ibrahim, FAMU College of Pharmacy
Tyler Fritsch, LECOM College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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