October 28, 2017 : Issue #909

• Risk Of Mortality In Patients with Type 2 and Prior CV Event
• Pre-Pregnancy Vitamin D Intake Reduces Gestational Diabetes Risk
• Safety And Efficacy Of New Long-Acting Exenatide Formulation
• Long-Term Benefits of Linoleic Acid In Type 2 Diabetes
• Can Vaccinations Increase Or Decrease Risk for Type 1 Diabetes?
• Exclusive: Joel Goldsmith on the Freestyle Libre and Other CGMs

The use of GLP-1 agonists just got easier. For the past couple of years, if your patient’s formulary paid for Trulicity, they had an easy time administering their dose. Adherence was improved because no mixing was necessary and you didn’t have to stare at the needle. Now Bydureon joins the easy-to-use team with their BCise pen, which requires no mixing. The added benefit of this formulation is that it is as effective as the twice-a-day formulation.

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We can make a difference!

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Dave Joffe

Editor-in-chief

See New Product.

The FDA has approved an auto-injector and new formulation of a once-weekly treatment for type 2 diabetes from AstraZeneca. Bydureon BCise offers a single-dose auto-injector for adults with type 2 diabetes. Bydureon BCise features a unique continuous-release microsphere technology delivery system that provides consistent levels of the product’s active ingredient, exenatide. The new formulation has shown the ability to reduce blood sugar levels alongside weight loss, despite not being a weight loss medication.

What do you use to diagnose prediabetes a majority of the time?

1) HbA1c
2) Fasting BG
3) IGTT
4) Other

Follow the link to see how you compare to your colleagues.

Joel Goldsmith is the Senior Director of Digital Platforms at Abbott Diabetes Care, which is focused on designing, developing, and commercializing software-based products and services that drive trial and sustained utilization of ADC’s sensor-based glucose monitoring solutions. He and his team created the FreeStyle Libre system, which comprises a tiny glucose sensor (0.2 inches in length, about the thickness of a hair) inserted through the skin and connected to a small, water resistant, plastic patch on the skin’s surface.

A 43-year-old patient with a 2-year history of type 2 diabetes presents to your office for a follow-up visit. She is a highly motivated patient and doesn’t have any significant co-morbidities, so together, you have set a target A1C= 6.5%. Her current medications are metformin and sulfonylurea. Despite her good efforts, her current A1C is 7.3%. You would like to add a third agent to her regimen, however, she is concerned about any additional weight gain as she has gained a few pounds since starting the sulfonylurea. Which drug class would you add to minimize any additional weight gain?

A. Basal insulin
B. GLP-1 agonist
C. Thiazolidine
D. DPP-4 Inhibitor

As medical professionals, we constantly get questions from our patients as to whether or not a particular nutritional can help with their condition. Then, if we are not sure, we look it up and find some studies that say they can be effective. But, what if none of the particular active ingredient is even in the product? If they take cinnamon to lower blood glucose and the product has none or very little cinnamon, then are we providing misinformation when we say that it can be effective?  In a current study of nutritionals, researchers found that mislabeling or omission of ingredients occurs frequently in herbal and dietary supplements, especially with weight loss products. To analyze the contents of herbal and dietary supplements and the frequency of mislabeling, the researchers collected data from 2,268 patients enrolled in the Drug Induced Liver Injury Network between 2003 and March 2016. Of the 341 supplements collected, the researchers have performed chemical analysis of 229 and found that 26 did not have any of the ingredients labeled. Analysis showed that 90 of 203 supplements showed accurately labeled contents (44%). The rate of mislabeling was 80% for 10 analyzed steroidal ingredients, 54% for 26 vitamin ingredients, and 48% for 122 botanical ingredients. They also found similar rates of mislabeling among 166 herbal and dietary supplements.  What this tells us is that not only is mislabeling common, but those mislabeled ingredients may very well be the cause of injury and actually do the opposite of what they were meant to do. Let you patients know, “Buyer beware.”

Navarro VJ, et al. Abstract 264. Presented at: The Liver Meeting; Oct. 20-24, 2017; Washington, D.C.

New study finds that adults with type 2 diabetes and atherosclerotic cardiovascular disease have increased risk of mortality with a prior nonfatal cardiovascular (CV) event.

Large cohort suggests supplement increase beneficial in women of reproductive age.

Once-weekly exenatide formulation can provide as much benefit as the traditional twice-daily dosing.

High linoleic acid level could reduce type 2 risk by 43 percent, new study found.

Flu shot, Pandemrix®, might reduce diabetes risk in children, study found.

Quote of the Week!

“Weakness of attitude becomes weakness of character.”

…Albert Einstein

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

Jessica Quach, Doctor of Pharmacy Candidate; GA-PCOM School of Pharmacy

Kay Lynn Tran, Doctor of Pharmacy Candidate: Class of 2018; LECOM College of Pharmacy

Fabio Rodriguez, Doctor of Pharmacy Candidate: Class of 2018; LECOM College of Pharmacy

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