August 26, 2017 : Issue #900

• Semaglutide Beats Dulaglutide in Head-to-Head Trial
• A New Perspective On Metformin Therapy In Type 1 Diabetes
• A Review of Adverse Events Related to Diabetic Foot Ulcers
• Predictors of Chronic Kidney Disease In Type 1 Diabetes
• Effects of SGLT-2 Inhibitors On UTIs and Genital Infections
• Exclusive: Scott Abbott on the V-Go Wearable Insulin Delivery Device

It was not uncommon a few years ago to take a patient off metformin when they went on insulin. Metformin was considered a type 2 drug and when someone either had type 1 or they became insulin dependent there was no real value for metformin. I spent 13 years working with an endocrinologist, and we would restart countless numbers of these patients on metformin only to have to explain the reasons when they went back to their primary care physician.

This week, our University of South Florida College of Pharmacy, Doctor of Pharmacy Candidate, Jessica Lambert, reviewed the latest research on the use of metformin with insulin and what she found will more than justify why we were doing this over a decade ago.

Also while we are on the subject of insulin use, you may want to review this week’s video with Scott Abbott as he explains why a mechanical continuous insulin infusion device can improve outcomes while lowering the risk of hypoglycemia.

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We can make a difference!

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Dave Joffe

Editor-in-chief

This type 2 diabetes injectable therapy will soon be unavailable. GlaxoSmithKline is alerting healthcare professionals that the company has made the decision to discontinue the commercial availability of Tanzeum (albiglutide for injection; 30mg and 50mg). The company states that this was not related to any safety concerns regarding the product, but rather due to limited prescribing of the drug. Tanzeum, a glucagon-like peptide-1 (GLP-1) receptor agonist, is indicated as an adjunct to diet and exercise, to improve glycemic control in adults with type 2 diabetes. It was approved by the Food and Drug Administration (FDA) in 2014.

How often do you recommend to your type 2 patients who are not on insulin to monitor their blood sugars daily?
1. Once a day
2. Twice a day
3. More than twice a day
4. Once a week or Less than daily

Follow the link to share your response.

Are you tired of having to write down your Blood Sugar test results? Would you like a way to get ride of the pen and pencil? Well try Diabetes Tracker. We take the K.I.S.S. approach.

Scott Abbott is the Director of Medical Development at Valeritas. He shares information from his presentation at the ADA on how the V-Go insulin delivery device can be used in the real world.

Your patient has been newly diagnosed with type 2 diabetes (A1C 7.7%) and you have prescribed metformin. Metformin should be titrated to minimize which side effect?

A. Rebound hyperglycemia
B. Reactive hypoglycemia
C. Weight gain
D. Gastrointestinal-side effects

Follow the link to see the answer.

You might want to consider going on that date rather than going to your spinning class if you want to live longer. A new study reported in the New York Post, a Brigham Young University-commissioned study, found that being single is more likely to kill you than obesity. Individuals with bad social connections had a 50 percent increased risk of an early death in comparison of those with good social connections, comparable to smoking roughly 15 cigarettes per day, according to the AARP. Alternatively, obesity increased an individual’s likelihood of an early death by 30 percent — a 20 percent drop on deadliness. “Being connected to others socially is widely considered a fundamental human need, crucial to both well-being and survival,” explained Dr. Julianne Holt-Lunstad, the lead author of the study and a professor of psychology at the university. “Extreme examples show infants in custodial care who lack human contact fail to thrive and often die, and indeed, social isolation or solitary confinement has been used as a form of punishment, yet an increasing portion of the U.S. population now experiences isolation regularly.”  In other words, that shame you feel (after a weekend of isolation) when you stare at your haven’t-showered-in-days reflection in Netflix’s “Are you still there?” screen isn’t just depressing — it’s deadly. The U.K. actually considers loneliness an epidemic, costing businesses $26 million per year in expenses from the health effects associated with isolation.

Semaglutide trumps Trulicity in most recent trial.

The evolution of metformin therapy through the decades.

Diabetic foot ulcers put patients at increased risk of falling.

CKD risk not necessarily tied to albuminuria in patients with type 1 diabetes.

Lowering HbA1c worth the risk of urinary tract and genital infections?

Quote of the Week!

“Strength and growth come only through continuous effort and struggle.”

…Napoleon Hill

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

Josephat Macharia, Doctor of Pharmacy Candidate: Class of 2018; LECOM College of Pharmacy

Jessica Lambert , Doctor of Pharmacy Candidate; USF College of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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