December 2, 2017 : Issue #914

• Calcium Score Predicts Future Heart Attack and Stroke Risk
• Beta-Blockers May Reduce Mortality in CHF Patients With Diabetes
• Semaglutide vs. Semaglutide in Treatment of Diabetes, Obesity
• Study Assesses Risk of Developing Diabetes, Reversing Prediabetes
• Treating Vitamin D Deficiency In Children With Type 1 Improves Glycemic Control
• Exercise to Lower Your Risk of Dying (Prematurely) with Type 1 Diabetes
  • by Sheri R. Colberg, PhD
• Exclusive: William Polonsky on the Psychological Aspects of Diabetes Treatment

It has been over 20 years since I started my journey in diabetes care. When I started, the education field was dominated by nurses and dietitians, and most of them were female. Oftentimes, when I was asked to serve on advisory boards for pharma companies, I would find I was the only pharmacist and the only male on the board. As my involvement grew, I often found myself on these boards with a gentleman who not only was a CDE but also a clinical psychologist. He brought a whole different perspective to diabetes care, and I would often spend time learning how best to communicate with my patients.

Our publisher, Steve Freed, caught up with this psychologist, Dr. William Polonsky, at the recent ADA Scientific Sessions, and Dr. Bill shared his perspective on patient use of glucose monitoring and how CGMs may be a whole new ballgame.

CGMs could be used for patients who are new to exercise, especially if you pair the device with Dr. Sheri Colberg’s feature on how exercise can help prevent premature death in type 1 patients.

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We can make a difference!

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Dave Joffe

Editor-in-chief

For your patients with an A1c of 6 to 6.4%, how much time do you allow them to use diet and exercise to lower their A1c before adding a medication? Follow the link to see how you compare to your colleagues.

Eli Lilly to include Dexcom CGM in Lilly’s Connected Diabetes Ecosystem. The companies expect to combine Lilly’s smart insulin delivery devices and Dexcom CGM to improve the future of diabetes management.

Sun Pharmaceutical Industries is recalling two lots of Riomet (Metformin Hydrochloride Oral Solution), which were found to be contaminated with Scopulariopsis brevicaulis. Learn more.

ReachMD lets healthcare professionals be part of the knowledge by discovering, participating in, and sharing medical education and clinical information through on demand programming and 24/7 radio broadcasts. Formats include video, audio, audio + slides, and text-based programs.

Dr. William Polonsky is President and Founder of the Behavioral Diabetes Institute, the world’s first organization wholly dedicated to studying and addressing the unmet psychological needs of people with diabetes.

A 47-year-old patient has done an excellent job with lifestyle modifications and medication adherence. However, she has not been able to yet achieve her individualized A1C goal. Her current regimen consists of a metformin, sitagliptin, and insulin detemir (insulin started 4 months prior). However, over the past month as she has titrated her basal insulin toward her A1C goal, her self-glucose blood monitoring log shows large drops in her overnight glucose levels. After consulting with the treatment team, you decide to add rapid-acting prandial insulin to her regimen. How would you implement this strategy?

A. Decrease the basal insulin dose and add 1 daily prandial injection before the smallest meal of the day.
B. Decrease the basal insulin dose and add 1 daily prandial injection before the largest meal of the day.
C. Maintain the basal insulin dose and add 1 daily prandial injection before the smallest meal of the day.
D. Maintain the basal insulin dose and add 1 daily prandial injection before the largest meal of the day.

Follow the link for the answer.

The number of children and teens diagnosed with type 2 diabetes has increased by 5 percent every year between 2002 and 2012.  You have read and heard about the recent opioid addiction and cancer, but the greatest threat to our youth is diabetes. This disease takes away years of life and includes a poor quality of life for many. This information is coming out of a recent national study from Wake Forest University.  But this information also comes from the CDC, recently published in the New England Journal of Medicine. We need to open our eyes that this disease dooms millions of Americans to an early death and costs over 200 billion dollars a year.  The percentage of children who are obese has more than tripled over the past half-century, which is also responsible for the increase in diabetes. More than 70 percent of people diagnosed with type 2 diabetes as children or teens suffer from at least one diabetes-related complication, which can include death. The Centers for Disease Control and Prevention estimates one in three Americans will have diabetes by 2050. The irony is that we know it is preventable.

We also know that our efforts to stop young people from contracting this disease have failed and we need a new approach. What we have seen in studies is that the best approach is one that is personal and manages diabetes on a person-by-person basis with rigorous, extensive, and individually targeted education programs.  If a child does not know what a carbohydrate is, they will be doomed to failure and an early death.  Type 2 diabetes is all about educating our youth to prevent this coming epidemic.

Reference: Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012(link is external), published in the New England Journal of Medicine.

Coronary artery calcium (CAC) scores better at predicting risk of cardiovascular disease (CVD) event in patients with type 2 than traditional scores.

UK-based study compares drug classes over 4-year period.

Study compares effectiveness of oral GLP-1 medication over injection.

Determining which patients benefit most from lifestyle, metformin interventions may improve individualized care decisions.

Use of cholecalciferol demonstrated reductions in HbA1c.

By Sheri R. Colberg, PhD: Much of the research on length of life for individuals living with type 1 diabetes is pessimistic, which makes a new study released recently a breath of fresh air. Data were collected for the ongoing nationwide, multicenter, Finnish Diabetic Nephropathy (FinnDiane) Study that tracked the death rate of 2,639 study participants.

Quote of the Week!

“Have patience with all things, But, first of all with yourself.”

…Saint Francis de Sales

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 2018, GA-PCOM School of Pharmacy

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
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Ewing, NJ, 08628
USA
www.diabetesincontrol.com