November 25, 2017 : Issue #913

• 1-Hour Post-Prandial Glucose Predicts Risk For Type 2 Diabetes
• Biosimilars Coming to Diabetes Treatments: How, What, Where, and When?
• Hypoglycemia Linked to Increased Risk of Cardiovascular Dysfunction
• Effect of Pioglitazone on Left Ventricular Diastolic Function
• New Faster-Acting Insulin Provides Faster Onset and Earlier Exposure Vs Insulin Aspart in Children with Type 1
• Exclusive: Julia Greenstein on JDRF

A few years ago I served as president of the Tampa Bay chapter of JDRF. At the same time one of my good Pharmacist-CDE friends was president of the local ADA chapter, and we would always tease each other as to who was raising the most money for our respective organizations. Since that time, it has often appeared that nationally the two organizations were in competition. This week, Steve sits down with Dr. Julia Greenstein, Director of Research at JDRF, to get her take on how the ADA and JDRF are working together and how the information from the ADA Scientific Sessions will be used to further JDRF’s goals.

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We can make a difference!

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Dave Joffe

Editor-in-chief

See New Product.

Do you believe that glucose monitors will be a thing of the past as continuous glucose monitors (CGM) become less expensive and more accurate?

Follow the link to see how you and your colleagues compare!

Once given FDA approval, the Senseonics Eversence System will be the fourth CGMS available in the U.S. It was submitted to the FDA for premarket approval last October, supported by data from a 90-patient pivotal trial of the device. The trial followed adults with type 1 or type 2 diabetes over 90 days of CGM sensor wearing. This is an implantable CGM system that is currently approved in Europe. The sensor sits just under your skin and can stay there for anywhere from 90-180 days.

Julia Greenstein, Ph. D. is the JDRF Vice President of Discovery Research, which includes early-stage programs across the JDRF portfolio. Dr. Greenstein has more than 20 years of experience in the corporate biotechnology arena, holding leadership positions that have helped accelerate discoveries to market.

A 54-year-old male presents to your office for an initial visit. His past medical history is significant for hypertension, hypertriglyceridemia and acute pancreatitis. His current lab results show an A1C 9.1%, which is confirmed on a repeat lab. You would like to start him on an antihyperglycemic treatment regimen. Which of the following two-drug combinations is contraindicated for this patient?

A. Metformin + a sulfonylurea
B. Metformin + an insulin
C. Metformin + a meglitinide
D. Metformin + a GLP-1 receptor agonist

Follow the link to get the answer.

53 studies were reviewed looking at lifestyle changes and medications in preventing diabetes to determine the best way to treat those at risk for diabetes. Lifestyle modification and medication can prevent people at risk of diabetes from developing the condition in the short term, but only lifestyle modification is associated with a sustained risk reduction, according to a meta-analysis published Nov. 6 in JAMA Internal Medicine. However, the benefit of lifestyle modification also declined over time, suggesting further interventions to preserve the effects are needed. The researchers extracted data encompassing 49,029 patients with prediabetes, defined as impaired glucose tolerance (IGT), impaired fasting glucose (IFG) or both, consistent with diagnostic criteria from the American Diabetes Association. The average age of the study population was 57. At the end of the active intervention phase, lifestyle modification was associated with a 39 percent decreased risk of developing diabetes while medications were associated with a 36 percent decreased risk versus control participants. After the intervention ended and at a mean follow-up of 7.2 years, patients with a lifestyle modification were 28 percent less likely to have progressed to diabetes. Those receiving medications did not maintain a significant risk reduction following the intervention. “Combined diet alterations and physical activity proved to be more effective in reducing progression to diabetes than either strategy alone by 44 percent,” the authors pointed out. Since caloric intake and physical activity are independently associated with reduced diabetes risk, combining these can be an additive effect.

Haw, J. S., Galaviz, K. I., Straus, et al. (2017). Long-term Sustainability of Diabetes Prevention Approaches: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Internal Medicine.

Study finds diabetes complications and mortality may be better predicted with elevated 1-hour blood glucose levels compared with 2-hour blood glucose levels.

Congress creates abbreviated licensure pathway for biological products similar to or interchangeable with FDA-approved products.

Severe hypoglycemia in type 2 diabetes was found to be associated with increased cardiac failure and mortality.

Diastolic function begins to decline in early stages of type 2 diabetes.

Insulin found to provide better control of post-prandial glucose without significantly elevating hypoglycemia risk.

Sign up for the next course from American Health Care’s continuing education series! Dr. Claude Lardinois, board certified endocrinologist and medical director of American Health Care, will be discussing a paradigm shift in the treatment approach of type 2 Diabetes Mellitus with established cardiovascular disease.

Please see the Diabetes Webinar Save the Date flyer for more information regarding this presentation.

If you would like to be added to the mailing list and receive an invitation for this course, please contact Yelena Andruh at: 916-960-2755 OR at y.zakharova@americanhealthcare.com.

Quote of the Week!

“The thankful receiver bears a plentiful harvest.”

…William Blake

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

Graciela Nieto, Doctor of Pharmacy Candidate 2018, LECOM School of Pharmacy

Fabio Rodriguez, Doctor of Pharmacy Candidate 2018, LECOM School 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