June 17, 2017 : Issue #890

Top News from ADA

• Exclusive: Dr. Bruce Neal Discusses Canagliflozin’s Potential for Heart Failure Prevention
• Canagliflozin Reduces Risk of Cardiovascular Disease, Hospitalization for Heart Failure; Associated with Renal Protective Effects
• My ADA Impressions: The Big Story
  • by Guest Writer David Kliff, Diabetic Investor
• Degludec Deemed Non-Inferior to Glargine Regarding Cardiovascular Safety in High Risk Patients with Type 2
• Cardiovascular Benefits seen with Long-Term Metformin Use in Adults with Type 1 Diabetes
• Praluent® (alirocumab) Associated with Reducing Risk of Cardiovascular Disease in Type 2 Diabetes

This is our first week back from ADA, and Steve and Joy did a fantastic job getting to the best of the best in the diabetes world. Instead of going old school and focusing on the usual thought leaders, they tried to find the new thinkers and ideas that are likely to shape care for the next decade.

Dr. Bruce Neal gave Steve an exclusive interview on the CANVAS study and the use of canagliflozin for heart failure prevention. He presented at the ADA Scientific sessions and then sat down with Steve to give him the inside, in-depth scoop. We also got an early view of a new product to help you know when your insulin has gone to a temperature that makes it unusable. MedAngel One is a new smartphone-powered device that lets you know if your insulin has been either too hot or too cold, making sure you don’t cause unexpected problems. Finally, guest writer David Kliff looks at the reasons why Apple, Amazon and Google all want to be in the Diabetes management business, and the reasons may surprise you.

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We can make a difference!

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Dave Joffe

Editor-in-chief

See this week’s Current Video Interview with Dr. Bruce Neal.

Would you consider using a combination of SGLT-2 Inhibitor along with an GLP-1 Agonist, now or in the future? Follow the link to see how you and your colleagues compare!

MedAngel ONE is the best solution to monitor and protect temperature sensitive medications like insulin. Continuous monitoring and logging ensures that you and your patients can always can always see beyond doubt if your medications were stored properly. It supports hundreds of FDA approved medications and adapts the smart alerts to them. If a dangerous temperature is approached or exceeded, the app will alert you immediately. Read on for details and for a special discount + Free shipping Use code: Med10.

Diabetes in Control speaks with top endocrinologists and other medical professionals to bring you the latest in diabetes news and research. This week, we have an exclusive interview from ADA 2017.

The CANVAS study’s outcomes were “a positive first step” in proving that canagliflozin can be used for the primary prevention of heart failure in patients with diabetes, but more evidence is needed, according to the study’s lead author, Dr. Bruce Neal.

A 78-year old patient with a 15-year history of type 2 diabetes arrives in your office for a check-up. He suffers from stage 3 chronic kidney disease and lives alone. From previous visits you have learned he has very few support services. What would be a realistic A1C treatment target for this individual?
A. A1C 6.0-6.5%
B. A1C 7.5-8.0%
C. A1C 8.5-10.0%
D. A1C 10.5-11%

Follow the link to see the correct answer!

Chocolate intake once a month or more is linked to a reduced Afib risk, with increasing risk reductions with increasing intake up to 2-6 servings a week.  Research has consistently indicated a cardiovascular benefit of chocolate consumption, but the 2 studies addressing Afib risk had mixed results. A Cochrane review has found BP-lowering effects of chocolate, with greater effects in people with higher baseline BP.  Another prospective study associated moderate chocolate intake with reduced myocardial infarction and ischemic heart disease risk. This study was done to evaluate the association between chocolate intake and incident clinically apparent atrial fibrillation or flutter (AF).  The Danish Diet, Cancer, and Health Study is a large population-based prospective cohort study. The present study is based on 55 502 participants (26 400 men and 29 102 women) aged 50–64 years who had provided information on chocolate intake at baseline. Incident cases of AF were ascertained by linkage with nationwide registries.  During a median of 13.5 years there were 3346 cases of AF. Compared with chocolate intake less than once per month, the rate of AF was lower for people consuming 1–3 servings/month, 1 serving/week, 2–6 servings/week and ≥1 servings/day, with similar results for men and women. From the results it was concluded that, accumulating evidence indicates that moderate chocolate intake may be inversely associated with AF risk.   https://dx.doi.org/10.1136/heartjnl-2016-310357

CANVAS Program results confirm cardiovascular benefits are SGLT-2 Inhibitor Class effect.

Why Google, Apple, and Amazon entering the diabetes market is the real big story from ADA.

The DEVOTE trial compared cardiovascular safety in two basal insulins; insulin degludec was found to have additional benefits.

Results from the REMOVAL trial revealed reduction in the risk of cardiovascular disease among other benefits with metformin in type 1 diabetes patients.

Results from two ODYSSEY studies indicate the favorable lipid lowering effects of Alirocumab, a PCSK9 inhibitor, in type 2 diabetes patients can potentially reduce the risk of cardiovascular disease.

Quote of the Week!

“Don’t watch the clock; do what it does. Keep going.”

… Sam Levenson

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

Joanna Martinez-Mendez, Lake Erie College of Osteopathic Medicine FL Campus, School of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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