December 12, 2015 : Issue #811

• Extremely Low Calorie Diet May Reverse Diabetes
• Testosterone Increasing Insulin Sensitivity
• Physical Activity Today Gives Lasting Benefits
• Assessing the Latest Information on SGLT-2 Inhibitors and Ketoacidosis
• Reducing Diabetes by Reducing Fat From the Pancreas
• Featured Writer: To Fitbit or Not to Fitbit?
• Special In-Depth Fact: Downloading of Data From Our Apps, Meters and CGM’s is Great. But How Do We Use It? 

We are 5 weeks away from the Consumer Electronics Show in Las Vegas. There will be over 170,000 people in attendance, and the total exhibit space covers over 7 square miles. Most everyone will want to see the biggest and best TVs, or the new cellphones, or the amazing things that are being done with 3-D printers. However more eyes will be turned towards telehealth management and use of the “cloud’ to manage chronic diseases, and diabetes will lead the way. 3 years ago there wasn’t even a single exhibitor in that space but for 2016 there will be around 100 companies from all over the world trying to sell us on the idea of IDM (Integrated Diabetes Management) for patients. This all sounds great, but will it really work?

Our good friend and colleague from Diabetic Investor, David Kliff, who I have toured CES with in the past, has taken a pragmatic look at the idea of IDM and shares the positives and the challenges that all of these companies and programs face.

Another big category at the CES will be fitness bands, such as the FitBit, Vivofit, Fuel and Jawbone. Last year we picked up a Misfit Shine and recently one of our wearers wrote a review (https://www.diabetesincontrol.com/for-your-patients-misfit-shine-activity-monitor/). Now that the gift giving season is upon us, many of our patients are looking for these as gifts to help them be healthier. This week we have a column from our expert Dr Sheri Colberg as she gives guidance on “To Fitbit or Not to Fitbit,” and why the best model may not be for all our patients.

Announcements:

Free CME Courses
Our web site CME resource is back online! Be sure to check out the new CME courses posted there. Courses are currently available on topics including: Advances in the Medical & Surgical Management of Obesity; Diabetic Retinopathy; Strategies to Improve Prevention and Treatment of Diabetes; and more!

dLifeTV.com: Sunday, December 13, 7PM ET

From dLife.com: “Charlie O’Connell talks about exercise and the Dawn Effect; Chef Michel Nischan cooks up some grilled shrimp and eggplant; Jim Turner talks with other people living with diabetes about how every day is tough; Golfer Megan McGann shares her experience of living with diabetes.” 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

Do you test your male patients with diabetes for testosterone?

The 5 A’s are meant to have the patient actually engage, activate, and change the behavior. The first is probably the most important, and that is “Ask.” So if you are in a primary care practice, not actively engaged in weight management and are seeing a patient for something else, it is important to begin the conversation by asking, “Is this a good time to talk about your weight?” Because if the patient is not ready to undertake behavior change, you are wasting the rest of the visit. The 5 A’s

A 39-year-old, overweight (BMI 27 kg/m2) patient comes into your office for his annual wellness examine. Routine labs show random plasma glucose of 176 mg/dL, so you ask him to return for a fasting plasma glucose and A1C. The results show a FPG 139 mg/dL and A1C of 7.7%. He is resistant to the idea of starting medication and is very keen on pursuing a trial period of dietary modifications and an exercise program, especially after you tell him about the benefits of moderate exercise on diabetes. Which of the following statements about exercise is true? Follow the link to answer!

According to Jenise Wong, MD, PhD, of the University of California San Francisco, who reported the results at an oral session at the joint meeting of the Endocrine Society and the International Congress on Endocrinology, “We need to really equip patients with better tools and education on how to use their data.”

David Kliff responds:

Now some would argue that this is why IDM is needed, as it not only collects and transmits data, but it provides for an easy interaction between the patient and their healthcare team; that it’s the healthcare team that’s doing all the data analytics; that all the patient needs to do is collect the data; and that this focus on data can actually make a patient tune out even when they are getting good advice. Here is a perfect example of what we are talking about. Read More

Study suggests extreme calorie reduction may have same effect as bariatric surgery.

A known link between low testosterone levels and decreased insulin sensitivity could lead to a treatment for men with type 2.

Positive effects can be seen decades later.

To maintain the benefits while minimizing risk, consider patient risk factors when prescribing, and monitor for DKA and UTI.

Study finds insulin secretion returns to normal with one-gram fat loss.

Having recently just tried a Fitbit physical activity tracking device (the Charge HR model) for the first time, I have noticed that in this post-Thanksgiving holiday sales time, everyone is selling them! But they are far from inexpensive. The American Diabetes Association also recently was involved in a FitForGood promotion that Fitbit ran that allowed them and two other nonprofit organizations to earn some extra money. Racking up extra steps for the ADA certainly motivated me and my family members to be more active—for a few days at least!

Quote of the Week!

“Science may have found a cure for most evils; but it has found no remedy for the worst of them all – the apathy of human beings.”

…Helen Keller

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

Janice W. Li,  PharmD intern

Jimmy Tran, PharmD Intern

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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USA
www.diabetesincontrol.com