June 3, 2017 : Issue #888

• When Do You Need a Checkup First Before Starting Exercise?
  • by Featured Writer Sheri Colberg, PhD
• Using a GLP-1 Agonist to Prevent Type 2
• Basal-Bolus Versus Once, Twice, and Even Three Times A Day of Long-Acting Insulin
• Improved Screening For Detecting Prediabetes
• Elevated Glucose A Risk for Cognitive Decline and Dementia
• The Cost Of Intensive Behavioral Counseling For Prediabetes Patients with CVD Risks?
• Current Video Interview: Dr. W. Timothy Garvey on Diabetes and Obesity

Whenever a TV doctor or “fitness expert” comes on TV with the next miracle weight loss exercise program, they always have a disclaimer that “you should see your healthcare professional before starting this or any exercise program.” I am not sure if it is a liability issue for the network or if they are just saying that to try to make their program seem more potent. For some people, this might be an excuse not to exercise because they think something will happen.

So, how do you know when you should see a provider before you start on a program? This week, our exercise guru, Sheri Colberg, joins us to help narrow down who needs a physical and who doesn’t.

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We can make a difference!

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Dave Joffe

Editor-in-chief

Which class of drugs would you prefer for a person with an A1c of 5.6%?
1) Only diet and exercise information
2) A GLP-1 receptor agonist
3) SGLT-2 Inhibitor
4) Metformin
5) Sulfonylurea

Follow the link to share your opinion and see what your colleagues think!

InRange is the easiest to use bolus calculator and diabetes logbook app available, helping you to quickly and accurately track your blood glucose levels.

Dr. W. Timothy Garvey MD, FACE, professor of Medicine and Chair of the Department of Nutrition Sciences at the University of Alabama at Birmingham, discusses diabetes and obesity in this exclusive interview at the AACE 26th Annual Scientific & Clinical Congress in Austin, Texas.

Basal insulin/GLP-1 combination medications versus each therapy separately for patients with type 2 diabetes: the combination medications are associated with all of the following properties EXCEPT:
A. Greater A1c reduction
B. Less insulin use
C. Lower rates of hypoglycemia
D. Weight gain

Follow the link to see if you got the right answer!

After 10 years of the DDPOS (DPP Outcomes Study), 2,029 participants, representing 74% of the cohort, were assessed at baseline and annually, and coronary calcium scans were done.  The scans were performed at a mean of 13.7 years after randomization, when the average ages of the participants were 67 years for men and 63 years for women. The mean duration of treatment was 9.6 years in the metformin group and 1.7 years and 1.3 years in the placebo and lifestyle groups, respectively. Diabetes developed in 54%, 59%, and 51% of the patients, respectively. The prevalence and severity of coronary artery calcium (CAC) after 14 years of metformin therapy were significantly lower in men, but not women, who started on the drug for prediabetes, in a longitudinal cohort study. Dr. Ronald Goldberg added that the metformin effect “occurred despite large numbers of individuals being on antihypertensive therapy and statin therapy.”  He also added that, “There is a background of information indicating that metformin might protect against heart disease in people with diabetes,” but this is the first time an effect has been seen in nondiabetic individuals. Metformin “seemed to be affecting the smallest lesions, and that might imply that the effect was on early atherosclerosis.” CAC was significantly less prevalent in males given metformin, at 75% vs 84% in the placebo group (P=0.02) and 84% in the lifestyle group (P<0.05). In contrast, no metformin effect on CAC was seen in women. The authors speculate that women may have less coronary calcification than men, making it harder to observe a benefit from metformin.  Published May 5, 2017 in Circulation.

How do you know if you need to see your healthcare provider for a checkup or medical clearance before you start any exercise training? You should have regular checkups at least annually with your doctor or another healthcare provider if you have any type of diabetes. This helps you keep on top of any problems that may pop up over time that have nothing to do with being physically active.

Results determined for 3-year study of liraglutide versus placebo diabetes risk reduction and weight management in individuals with prediabetes.

Research compares health outcomes in four insulin regimens.

New research suggests HbA1c may be the most effective method to identify patients with undiagnosed prediabetes.

Glucose peaks tied to greater cognitive decline for those with diabetes and A1c ≥7.0 percent.

Results showed that the intervention will be cost effective.

Quote of the Week!

“The greatest discovery of my generation is that a human being can alter his life by altering his attitudes.”

…William James

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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Ewing, NJ, 08628
USA
www.diabetesincontrol.com