Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.
Letter from the Editor
The results of the SPRINT trial included 9361 hypertensive patients 50 years of age or older randomized to either a standard systolic blood pressure target of 140 mm Hg or an intensive treatment target of 120 mm Hg. The primary (composite) outcome was myocardial infarction, other acute coronary syndromes, stroke, heart failure or death from cardiovascular causes. The trial was stopped early by NIH due to a substantial benefit demonstrated in the intensive treatment group.
As compared to patients in the standard treatment group, trial participants in the intensive group had a:
* 25% lower relative risk of the primary outcome
* Lower rate of heart failure (38% relative risk reduction)
* Lower rate of cardiovascular death (43% relative risk reduction)
* Lower rate of death from any cause (27% relative risk reduction)
According to the authors of the study, “The results add substantially to the evidence of benefits of lowering systolic blood pressure, especially in older patients with hypertension. Targeting a systolic blood pressure of less than 120 mm Hg, as compared with less than 140 mm Hg, in patients at high risk for cardiovascular events but without diabetes resulted in lower rates of fatal and nonfatal major cardiovascular events and death from any cause.”
One of the regimens included the use of the ARB, azilsartin medoxomil and the diuretic, chlorthalidone, an older and less known diuretic. If you want to know why chlorthalidone is such a good choice and why it was the cornerstone diuretic in the landmark SHEP and ALLHAT studies, you will definitely want to check our Item 3. If you want to learn more about the results of the SPRINT study, then click here.
Announcements:
Diabetes Summit 2016
DIC Publisher Steve Freed will be attending the GTCbio 2016 Diabetes Summit, to be held April 25-27, 2016 in Boston, MA. This unique event encompasses the drug discovery and partnering aspects of diabetes in two individual conferences that take place concurrently. Click here for more information.
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, February 28, 7PM ET
From dLife.com: “dLife brings you the harrowing story of Ernest Sterzer, a type 1 teenage who survived the unthinkable in Nazi Germany. Also, a special tribute to the late, great sports legend, Ron Santo.” 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
This Week's Poll
Which of the healthcare solutions proposed by the 2016 presidential candidates do you think would be best? Follow the link to share your opinion!
1. Build on and improve the Affordable Care Act
2. Repeal and replace the ACA
3. Have a single payer “Medicare for all” system
4. Other
Tool for Your Practice: Revised Insulin Overview 2016
A complete list of the stability and expire dates for all the insulin and other injectable that are used to control blood sugars. Stability of insulin chart 1-13-2016
Test Your Knowledge
Mr. Hernandez is an overweight (BMI 30 kg/m2), 45-year-old plumber of Hispanic heritage who arrives at your office for a first-time visit. He has not been to a physician during the last 7 years because he hasn’t always had health insurance and “doesn’t like going to the doctor.” However, he has been noticing lately that his vision seems a little blurry and he’s developed a red, itchy rash in his groin. He is a non-smoker and recalls being told a long time ago that he should eat a low salt diet, but he can’t remember why. On examination, his BP is 154/96 mm/Hg, and his pulse is 72, RR 22. His physical exam is notable for signs of a yeast infection in his groin. You order a CBC, Chem 12 panel and A1C to be drawn that day before he leaves. You advise him how to treat his skin infection. When you receive the results of the Chem 12 panel, it shows a random plasma glucose of 162 mg/dL and A1C 7.3%. You call Mr. Hernandez and ask him to return the next morning, before he has eaten, for additional labs. You order the necessary labs.
Mr. Hernandez labs return and are notable for A1C 7.5, FPG 137 mg/dL, LDL-cholesterol 190 mg/dL, HDL-cholesterol 38 mg/dL and triglycerides 232 mg/dL. You discuss his lab results, his diagnosis and how to manage diabetes and make referrals to the appropriate diabetes team clinicians. You start Mr. Hernandez on metformin, lifestyle modifications, an ACE inhibitor, and a statin. You are looking to achieve A1C <7%, BP<140/90 mmHg, LDL<100 mg/dL You ask Mr. Hernandez to return in 3-months time to evaluate how everything is going. However, he fails to keep his appointment. He returns 1 year after his initial diagnosis for a recurrent yeast infection. His A1C is currently 8%. Upon questioning, he admits that while he has been good about taking his “heart meds,” he has not taken the “sugar pill” because he didn’t like it. What side effect did the patient most likely find intolerable? A. Diarrhea and abdominal cramping B. Paresthesias C. Increased appetite D. Insomnia Follow the link to see the correct answer.
Did You Know: Researchers Use Satellite Images to Predict Cancer and Obesity Rates
Satellite images are being used to highlight association between artificial lighting at night and incidence of diseases such as obesity, breast cancer and prostate cancer all around the world. There is no doubt that the effects of artificial lighting on humans, other living creatures and vegetation on the planet Earth in general is considerable. New Israeli research has found that there is a significant positive connection between the strength of artificial lighting emitted from various places on the planet at night, as measured with the help of satellites, and the frequency of breast cancer. According to the research, artificial urban lighting in various parts of the globe can provide a great deal of information about a wide variety of areas, from economic activity, production output and urban planning to insights into the local way of life and finding additional factors for one of the greatest disorders of recent years — obesity. In the modern way of life, there is also a dangerous connection between artificial light and health problems. One of the connections that have been proven is between artificial lighting and obesity. For example, in shift workers whose reversed way of life manages to confuse the melatonin mechanism. The Israeli researchers found that increased exposure to artificial lighting at night is significantly correlated with obesity. Plus, prolonged exposure to artificial lighting at night is also connected to various types of cancer. — The International Journal of Obesity, Feb, 2016,: The International Journal of Obesity, Jan. 2016
Is there actual benefit in dual therapy treatment?
New study shows reduction in hypoglycemia.
New study shows medication superior to HCTZ when lowering blood pressure in patients.
New study examines cardiovascular impact of higher levels of exercise.
Despite multiple studies on the topic, it’s still unclear whether eggs increase the risk of developing type 2 diabetes.
Synthetic pancreases may be the wave of the future for type 1 diabetics, but are they safe and effective in adolescents?
Quote of the Week!
“Like a welcome summer rain, humor may suddenly cleanse and cool the earth, the air and you.”
…Langston Hughes
Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletter:
Javeria Fayyaz, LECOM College of Pharmacy
Devon Brooks, LECOM College of Pharmacy
Adaisha C. Rutledge, FAMU College of Pharmacy
Your Friends in Diabetes Care
Steve and Dave
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