September 9, 2017 : Issue #902

• PCPs Lack Knowledge of Prediabetes Risk
• Atherosclerotic Cardiovascular Disease Risk (ASCVD) in Diabetes Patients
• Diabetes At Work: The Patient’s Rights and Benefits
• Blood Glucose Test Strips: To Reimburse or Not to Reimburse?
• What Is And Isn’t News in Diabetes Drugs and Devices
• Exclusive: Leigh Perreault on Diabetic Obesity

This week we have a great feature from David Kliff on what is the newest and greatest for diabetes care, and what some of the problems will be. But I would rather look at a couple of old school products that we should be more aggressive with.

The first is metformin and the idea of using this product for prediabetes. There are clinicians who do take advantage of metformin, but many more have no idea of why. Check out item number one to find out why our staff feels that most PCP’s don’t know enough about prediabetes.

The other old school product is glucose monitoring strips, and why insurers should pay for them — and how this inexpensive product can make such a difference in diabetes patients, especially those with type one.

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We can make a difference!

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Dave Joffe

Editor-in-chief

What percentage of your prediabetes patients do you recommend a pharmaceutical treatment?

1. 10-25%
2. 25-50%
3. Greater than 50%
4. Zero. I only recommend diet and exercise.

Follow the link to share your response.

Which of the newer drugs provide the best results in lowering blood sugars? Download the Top A1c-Lowering Drugs Chart (pdf) here.

As advances in diabetes treatment evolve at a rapid-fire pace, Diabetes Is Primary targets clinicians on the frontlines of primary care. This program delivers easily accessible continuing education to meet the needs of busy PCPs. The program is based on the ADA’s Standards of Medical Care in Diabetes—the gold standard in diabetes treatment. Additionally, Diabetes Is Primary helps PCPs navigate the complex changes in the health care industry, including new therapies and their costs, population health, and more. Learn about the ADA guidelines and much more. Join us on Wednesday, October 25, 2017 from 7am-3pm at the Drury Lane Conference Center in Oakbrook Terrace, Illinois for the Diabetes is Primary educational conference. This medical education initiative will offer up to 5 continuing education credits, lunch, and a one year, free professional membership to the American Diabetes Association. Catch the early bird cost to attend ($75) until September 15, 2017. Learn more here: www.professional.diabetes.org/DIPChicago. Register here: www.diabetes.org/dipchicago

The FDA tentatively approved Sanofi’s rapid acting insulin analog Admelog, which is similar to Lilly’s Humalog.

Oramed Pharmaceuticals announced that the FDA has agreed to schedule an End-of-Phase II meeting for its successfully completed Phase IIb trial of its oral insulin capsule ORMD-0801.

At her last visit, your patient’s labs showed a eGFR 55 ml/min/1.73 m2. At this visit, her labs measured an eGFR of 44 ml/min/1.73 m2. Dose reduction/cessation should be considered for all of the following agents EXCEPT:

A. Glyburide
B. Sitaglipitin
C. Metformin
D. Pioglitazone

Follow the link for the correct answer.

In a recent study, researchers found that a high-fat diet may reduce mortality. According to research presented at the European Society of Cardiology’s annual meeting and published in The Lancet, data from 135,000 people in 18 countries over seven years found high fat intake was associated with a lower risk of death, while high carbohydrate consumption increased it. The study also found eating fruits, vegetables, and legumes reduced mortality risks, but the benefit capped off at three to four servings daily. So what does this all mean? Well, a hamburger may be OK to eat, and adding lettuce and tomato to the burger is still good for you, but an excess of white flour burger buns may boost your risk of dying early.

The research team tracked the participants’ health for about seven years on average, with follow-up visits at least every three years. The investigators found that high-carbohydrate diets are common, with more than half of the people deriving 70 percent of their daily calories from carbs.

Lead author Mahshid Dehghan, an investigator with the Population Health Research Institute at McMaster University in Ontario, stated that people with a high fat intake — about 35 percent of their daily diet — had a 23 percent lower risk of early death and 18 percent lower risk of stroke compared to people who ate less fat.  The researchers also noted that a very low intake of saturated fats (below 3 percent of daily diet) was associated with a higher risk of death in the study, compared to diets containing up to 13 percent daily.  At the same time, high-carb diets — containing an average 77 percent carbohydrates — were associated with a 28 percent increased risk of death versus low-carb diets, Dehghan said.

The study was scheduled to be presented Tuesday at the European Society of Cardiology annual meeting in Barcelona, Spain. The research was being published online as two studies on Aug. 29 in The Lancet.

Recent published study showed that health care providers may lack the knowledge to diagnose and even treat prediabetes.

Treatment of hypoglycemia contributes to ASCVD risk reduction.

A person cannot be denied health care coverage and benefits because they have diabetes prior to employment.

T1D patients with certain characteristics would benefit the most from reimbursement of blood glucose test strips.

David Kliff from Diabetes Investor adds his thoughts about what is happening in the diabetes marketplace.

Dr. Leigh Perreault is an associate professor of medicine, physician and clinical researcher at the University of Colorado Denver School of Medicine, Aurora, CO. Her overarching research interest lies in understanding the different pathways by which people develop type 2 diabetes, and developing tailored strategies for diabetes prevention. Complementing her independent research interests, Dr. Perreault works closely with collaborators examining emerging risk factors for diabetes such as sleep restriction, intramuscular lipids and the human microbiome.

Quote of the Week!

“You have power over your mind – not outside events. Realize this, and you will find strength.”

…Marcus Aurelius

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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