April 22, 2017 : Issue #882

• Metformin and Aging
• Pathway to CKD
• Elderly Women at Higher Risk of Developing Diabetes While Taking Statins
• Glucose Control and Microvascular Complications
• Insulin Pump vs. Multiple Injection: Which Is The More Effective Treatment?
• Children, Adolescents With Diabetes Might Be Missing Out on Retinopathy Screenings

For many years, we never really gave great concern to the micro- and macrovascular problems in type 2 patients. Most of them were not diagnosed until they were in their late 50’s or early 60’s, and they did not really live long enough to develop severe problems. Now that diabetes begins as early as the teen years, that concept has had a radical change. We see 12-year-olds starting on metformin and other medications. These patients will have 50 to 60 years to develop the complications of diabetes, so testing and treatment have to start earlier.

This week, we feature a multitude of items focused on earlier treatment and prevention, including one on the relationship of daily glucose control to the development of vascular problems.

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We can make a difference!

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Dave Joffe

Editor-in-chief

Genentech’s Lucentis® (ranibizumab injection) 0.3 mg is now approved for the monthly treatment of all forms of diabetic retinopathy. Diabetic retinopathy is the most common cause of vision loss in people with diabetes and the leading cause of blindness among adults aged 20 to 74.  Lucentis is the first and only medicine FDA-approved to treat all forms of diabetic retinopathy.

Keith Campbell, Distinguished Professor in Diabetes Care/Pharmacotherapy at the Washington State University College of Pharmacy and Diabetes in Control Advisory Board member, will be recognized for his outstanding commitment and lifetime of service to the WSU College of Pharmacy and the pharmacy profession at the university’s inaugural “Crimson Gala” to be held Friday, Oct. 20, 2017 as part of Pharmacy Homecoming Weekend. Campbell is distinguished as one of the first pharmacists to become a certified diabetes educator, having continuously encouraged a vast number of colleagues to do the same. Proceeds from the gala will be used to name the “R. Keith Campbell” Applied Patient Care Lab in the Pharmaceutical and Biomedical Sciences Building in Spokane. The gala will be held at the DoubleTree Hotel in Spokane from 5:30 p.m. to 9 p.m.

Do you use texting and/or email with your patients? Follow the link to see what your colleagues have to say!

The Courage-Wisdom-Hope kit is intended to help parents, siblings and children adjust to life with the disease, by providing supportive and educational guidebooks that set families up for success.  Our Courage-Wisdom-Hope Kit for children and their families helps every kid feel smart, brave and ready to live a great life.  This free kit cannot replace the need to see your health care professional team, but it may help you fill in some blanks. Contents include: Parent Guide, Kid’s Interactive Guide, Sibling Guide, Drawstring “go” bag—sized for a meter, strips, glucose tablets, snack and other necessities, Write-on emergency contacts magnet and pen.  Patients can visit https://diabetes.org/newlyT1D or call 1-800-DIABETES (800-342-2383) to learn more about this new resource.

There is an antidiabetic medication available on the U.S. market with an indication from the U.S. Food and Drug Administration (FDA) to prevent cardiovascular (CV) disease.

A. True
B. False

Follow the link to see the answer!

While glucose tablets have been advocated for treating symptomatic hypoglycemia in awake patients, dietary sugars may be more convenient and more effective in treating hypos. A systematic review compared the impact of these treatment options on the relief of symptomatic hypoglycemia, time to resolution of symptoms, blood glucose levels, complications and hospital length of stay. PubMed, Embase and the Cochrane Library through June 28, 2016 was searched and assessed the quality of evidence using the Grades of Recommendation, Assessment, Development and Evaluation approach. Reference lists from a subset of the resulting articles were mined for additional, potentially eligible papers. Then the risk ratio (RR) of each treatment option for the preselected outcomes of interest was done. Results showed that of  the 1,774 identified papers, four studies met the inclusion criteria; three randomized controlled trials totaling 502 hypoglycemic events treated with dietary sugars and 223 with glucose tablets, and one observational study with 13 events treated with dietary sugars and 9 with glucose tablets. The dietary forms of sugar included sucrose, fructose, orange juice, jelly beans, Mentos, cornstarch hydrolysate, Skittles and milk. In the pooled analysis, patients treated with dietary sugars had a lower resolution of symptoms 15 minutes after treatment compared with glucose tablets. From the results, it was concluded that compared with dietary sugars, glucose tablets result in a higher rate of relief of symptomatic hypoglycemia 15 minutes after ingestion and should be considered first, if available, when treating symptomatic hypoglycemia in awake patients. — Emerg Med J. 2017;34(2):100-106. © 2017  BMJ Publishing Group; co-owned by the Royal College of Emergency Medicine and BMJ

Study shows age-related comorbidities decreased in males over 65 who take metformin.

Study looks at the heterogeneity of CKD in type 1 diabetes.

The risks may be outweighing the benefits, but only to a point.

Big changes to affect small vessels.

Proper training key to best results in both groups.

Race, socioeconomic status thought reasons behind lack of adherence to the recommendations.

Quote of the Week!

“Success consists of going from failure to failure without loss of enthusiasm.”

….Winston Churchill

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

Priscilla Rettman, Philadelphia College of Osteopathic Medicine – GA Campus

Mark T. Lawrence, University of Colorado-Denver, School of Pharmacy NTPD

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