July 30, 2016 : Issue # 844

• Canagliflozin as a Monotherapy in Type 2 Diabetes
  • More SGLT-2 News – In Case You Missed It:
    Heart and Kidney Benefits for Empagliflozin | Why Do Doctors Hesitate to Prescribe SGLT-2s? | SGLT-2s for Type 1?
• Effect of Lipid Lowering Drugs on Type 2 Diabetes
• Should we Exercise at a Particular Time of the Day, or at Our Convenience?
• The Use of Technology in Medical Practice
• Diabetes, Kidney Problems and Cardiovascular Risk in Minority Patients
• Can Aloe Vera Play a Role in Managing Type 2 Diabetes?

There is an old saying in medicine: “above all do no harm.” This term often comes into play when our patients ask us about nutritional products for diabetes and other diseases, as well as when someone tells us about the greatest new exercise program to “cure” diabetes. This week we have some great examples of how to maximize care with non-pharmaceutical products.

Item #6 looks at the value of Aloe Vera for our patients, and the practice pearls alone are enough to memorize. We also look at the value of circadian rhythm and how this affects exercise; Dr. Sheri Colberg chimes in with her best tips related to these questions.

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

We can make a difference!

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

Dave Joffe, Editor-in-chief

Do you enjoy and ride a bike for exercise? Follow the link to respond!

FDA approves once-daily injection Adlyxin (lixisenatide) a GLP-1 drug to treat type 2 diabetes.

The pinprick or sharp sensation test is acknowledged and recommended by the ADA as a useful and sensitive method of testing for Loss Of Protective Sensation and predicting serious complications associated with diabetes. Medipin is a unique single use cutaneous pinprick testing device. Its patented precision technology has been designed to enhance patient pinprick sensation response.

Which of the following is the correct diagnostic cut-point for diabetes?

1) A1C greater than or equal to 7%
2) Fasting plasma glucose (FPG) greater than or equal to 130 mg/dL
3) 2-hour plasma glucose greater than or equal to 200 mg/dL during an oral glucose tolerance test
4) Random plasma glucose greater than or equal to 300mg/dL in a patient with classics symptoms of hyperglycemia or hyperglycemic crisis

Did you get it right? Follow the link to find out!

According to research from Duke Health, walking briskly on a regular basis can be more effective than vigorous jogging for improving glucose control in individuals with pre-diabetes. The published findings are the result of a randomized, six-month study of 150 participants, each of whom was designated as having pre-diabetes based on elevated fasting glucose levels. The participants were randomized into four groups. The first group followed an intervention modeled after the Diabetes Prevention Program (DPP), considered a gold standard, that aims to achieve a 7 percent body weight reduction over 6 months. The program requires cutting calories, eating a low-fat diet, and exercising. Study participants in this group adopted the diet changes, and performed moderate-intensity exercise equivalent to 7.5 miles of brisk walking in a week.  Other study participants were randomly assigned to receive exercise only, using different amounts and intensities: low-amount at moderate intensity (equivalent to walking briskly for 7.5 miles per week); high-amount at moderate intensity (equivalent to walking briskly for 11.5 miles per week); and high-amount at vigorous intensity (equivalent to jogging for 11.5 miles per week).  They wanted to know how much of the effect of the DPP could be accomplished with exercise alone, and which intensity of exercise is better for controlling metabolism in individuals at risk for diabetes.  On average, participants in the DPP group had the greatest benefit, with a 9 percent improvement in oral glucose tolerance—a key measure of how readily the body processes sugar and an indicator used to predict progression to diabetes.  Diabetologia published online July 15, 2016

Is the SGLT-2 inhibitor best used along with metformin, or is canagliflozin as a monotherapy a good choice?

ETC-1002 may offer new therapeutic option that does not decrease glycemic control.

Is there a best time to work out, based on circadian rhythms?

How do consumers and HCPs feel about new technologies and their impact on our health system?

Prevalence of early CKD higher among Hispanics and African Americans.

Studies suggest aloe vera has antidiabetic properties, but is the research sound?

Quote of the Week!

“The key to abundance is meeting limited circumstances with unlimited thoughts.”

…Marianne Williamson

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