March 26, 2016 : Issue #826

• The Use of EHR in Diabetes Patients Through Cohesive Care Teams
• Percentage of United States Citizens Who Intake Excess Sodium
• French Fries vs. Pasta for Better Postprandial Glycemic Control
• Statins and Memory Loss
• The Association Between Uric Acid Levels and Chronic Kidney Disease (CKD)
• How Much Does Our Government Pay for Health Services?

Now that the political parties have narrowed the field on both sides of the aisle, they are finally starting to talk about issues instead of throwing barbs at each other. This in no way means that there won’t be a whole lot of mudslinging in the next eight months, but they will all sooner or later have to share their plans if they are elected. You can bet that healthcare will be one of the hot topics and whether you are in favor of socialized medicine or of repealing the Affordable Care Act, whatever happens is bound to affect all of us involved in healthcare.

Many ads on TV will be forthcoming on this issue and a lot of these will be focused on how much we pay for healthcare, either out of our pocket in co-pays and premiums or tax dollars spent. This week, our Doctor of Pharmacy Candidate, Devon Brooks from LECOM College of Pharmacy, is sharing his research on how much we actually spend on healthcare and what are the predicted changes over the next 5-10 years (Item 6).

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, March 27, 7PM ET

From dLife.com: “dLife explores the diabetes/depression connection. Plus, a healthy breakfast favorite in the dLife kitchen, and another amazing diabetes makeover.” 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.

*****************************

We can make a difference!

*****************************

Dave Joffe, Editor-in-chief

If you could have any A1c result regardless of your health, even if you don’t have diabetes, what A1c number would you like to have? Follow the link to respond and see what others think.

The Doc Halo Mobile Health Platform is the leading clinical communication system for healthcare. The mobile app and online console provide secure, HIPAA-compliant texting for the safe transmission of protected patient information.

Mr. Carlson is a 52-year-old Caucasian grocery store manager you saw last week for a new patient visit. His labs from that visit were significant for elevated random plasma glucose 166 mg/dL, A1C 7.4% and elevated lipids (TG=175 mg/dL, LDL 148 mg/dL, HDL 38 mg/dL, total cholesterol 221 mg/dL). He has returned to your clinic for a follow-up appointment. His physical exam is notable for central abdominal obesity (waist circumference 42”), left eyelid xanthelasma, BP 147/91, HR 72, RR 18, BMI 36 kg/m2, but otherwise normal. A repeat A1C test shows A1C 7.6%. Mr. Carlson smokes between 1 and 1.5 packs of cigarettes daily. After discussing the labs and your findings with Mr. Carlson, you begin collaborating on a management plan. You write prescriptions for metformin, a statin and ACE inhibitor. Mr. Carlson doesn’t think “taking medication will be too tough,” but expresses skepticism about your recommendations for a change in his diet, exercise and smoking programs because he has tried them, without success, in the past. What is considered the starting BMI for consideration of bariatric surgery?

Select one answer:
A. BMI greater than 28 kg/m2
B. BMI greater than 30 kg/m2
C. BMI greater than 35 kg/m2
D. BMI greater than 37 kg/m2

Are you right? Follow the link to find out!

A new study at Yale School of Medicine found the spike in blood glucose levels that can come after a meal is controlled by the brain’s neuronal mitochondria, considered the “powerhouse of cells.”  The findings could provide a better understanding of how type 2 diabetes develops. Blood glucose levels are thought to be primarily controlled by the pancreatic hormone insulin, the liver, and the muscles. This new study, however, highlights a crucial role for mitochondria in a small subset of neurons of the brain in systemic glucose control. The study was designed to explore how neurons in the brain adapt to the glucose “rush.” The researchers were surprised to find that not only do mitochondria of neurons “feel” the change in circulating glucose levels, but that adaptive changes in these same mitochondria are at the core of the body’s ability to handle sugar in the blood. They found that when sugar increases in the body, mitochondria in subsets of brain neurons rapidly change their shape and their function is altered. These seemingly subtle adjustments in a “housekeeping” cellular event in a handful of brain cells have a surprisingly powerful impact in circulating glucose levels by affecting many peripheral tissue functions. The findings imply that alterations in this mechanism may be crucial for the development of metabolic diseases such as type 2 diabetes, in which the body is not able to clear the blood from high levels of sugar that occur after meals.  Published in the Feb. 25 issue of the journal Cell.

How much effect does healthcare team cohesiveness have on EHR-associated treatment in diabetics?

Study finds high sodium intake common in both adults and children.

Is there a difference when children consume carbs as part of a meal?

Statins are a mainstay in diabetes therapy, but connections have been made between memory impairment and their use.

Can high uric acid levels be an indicator of changes in kidney function?

It’s generally thought that most U.S. healthcare is funded by private insurance; however, the majority of costs may actually be funded by the government.

Quote of the Week!

“You cannot have a positive life and a negative mind.”

…Joyce Meyer

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

Devon Brooks, LECOM College of Pharmacy

Jennifer Zahn, USF College of Pharmacy

Sabair Pradhan, USF College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
810 Bear Tavern Road Suite 102
Ewing, NJ, 08628
USA
www.diabetesincontrol.com