December 18, 2015 : Issue #812

• Structured Personal Diabetes Care Reduced Mortality Rates in Women, Not Men
• Victoza Vs. SGLT-2 inhibitor for Better BG Control
• Controlled Type 2 Patients Being Over Treated
• Risks and Benefits of GLP-1s
• Insulin Secretion Restored At Diagnosis of Type 1 With Tight Control
• Where Do SGLT-2 Inhibitors Fit in Diabetes Care?

This time of the year always causes Steve and me to reflect on how lucky we are to be able to have been part of you and your patients’ lives for over 16 years. We are thankful to those of you who supported us when we were 2 pharmacists sharing our ideas on diabetes care, and we have always appreciated the support and feedback that you have given us over the years.

This interaction between you, our readers and friends, has made us very proud to be involved with the diabetes community. We are also thankful to the great medical professionals who have graciously shared their time, talents and presentations over the years, so we could bring you insights and information that no other publication can. We are also grateful for our hard working staff and to EHS, our parent company, who we joined almost 2 years ago.

For many of you the next two weeks will be a time for family and friends and reconnecting with people we have not seen for some time. All of us here at Diabetes in Control want to take this opportunity to wish each of you and your loved ones a wonderful holiday season.

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 20, 7PM ET

From dLife.com: “Charlie O’Connell of FitScript works with diabetes patient James Butte to overcome the challenges of exercising with a disability; Chef Michel Nischan shows us how to prepare a delicious fried catfish; Joy Pape RN,CDE answers your diabetes questions from the dLife mail; Guess your carbs with Divabetic’s Carb Kitty; Benno Schmidt revisits the Coalition of Pastors Spouses for an episode of ‘Where Are They Now?'” 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

Of the new medications for type 2 patients, which one do you prefer most for an overweight type 2 patient with an A1c of 8.5% after putting them on metformin? Follow the link to respond.

The U.S. Food and Drug Administration (FDA) approved the newest diabetes treatment from the Lilly-Boehringer Ingelheim diabetes alliance. The FDA issued a press release regarding the approval, which can be accessed here.

Meal Memory is a new approach to nutrition tracking. It helps diabetes patients understand how each meal affects them by displaying blood sugar readings from before and after eating.

Agency sees no need for restrictions after easing them two years ago:  The FDA is doing away with the Risk Evaluation and Mitigation Strategy (REMS) for the type 2 diabetes medication that contains rosiglitazone (Avandia).  The REMS was “no longer necessary to ensure that the benefits” of the drug outweigh its risks, the FDA announced on its website recently. The drug has been under scrutiny since 2007, when a meta-analysis found that rosiglitazone was linked to risk of myocardial infarction.

A 59-year-old patient who was diagnosed with type 2 diabetes five years ago presents to your clinic for an appointment. He has a history of hypertension and dyslipidemia, both currently well controlled with medication. He has been taking metformin and a DPP-4 inhibitor. He tells you he is concerned about a sore on his foot that is taking a long time to heal. At today’s visit, his office A1C is 8.8%. After discussing his options, you decide to add basal insulin analogue detemir to his regimen. Compared to insulin NPH, what would you expect him to experience while taking detemir? Follow the link to answer.

A study in The BMJ found that patients who take the anticoagulant warfarin plus sulfonylureas are 22% more likely to be hospitalized or visit an emergency department due to hypoglycemia. Findings were based on 466,000 Medicare patients. Warfarin strengthens the effects of sulfonylureas, potentially causing rapid drops in blood sugar, particularly among men ages 65 to 74. Patients taking both drugs should be monitored carefully and may need to check blood sugar more frequently, experts said. “An interaction can occur that has clinical significance, so providers need to be aware in order to prevent a low blood sugar issue from occurring,” study co-author Anne Peters, a professor in the USC School of Medicine, said in the news release.  Clinicians need to be more vigilant when a sulfonylurea is added to a regimen that includes warfarin, as well as when a patient who is taking both has a change in their medical status.  Published Dec. 7, 2015 in the journal BMJ.

New study showed women accept disease, implement disease management more easily.

Safety, efficacy of these new classes of diabetic medication require more detailed investigation.

Nearly half of patients with stable A1c, who do not use insulin, found to be unnecessarily tested three to four times a year.

Systemic review, network meta-analysis found treatment resulted in greatest reductions in HbA1c, fasting blood glucose, and body weight.

New study focuses on isolated islets of Langerhans.

Various T2 factors create need for multiple treatment options.

Quote of the Week!

“I can accept failure, everyone fails at something. But I can’t accept not trying.”

…Michael Jordan

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
810 Bear Tavern Road Suite 102
Ewing, NJ, 08628
USA
www.diabetesincontrol.com