March 3, 2018 : Issue #927

• Is Poor Glucose Control and High Prevalence of Obesity Expected with Early-Onset T2D?
• Microneedle-Array Patches: An Innovative Way to Treat Type 2 Diabetes
• New Diet Trend Can Help in Management of Diabetes
• Exenatide Osmotic Mini-Pump Safety and Efficacy
• Managing the Risk of Hypoglycemia in Adolescents with Type 1 Diabetes
• Get off the Couch and Work Your Core: 10 Exercises for Core Fitness
  • by Sheri Colberg, PhD

Many years ago, when Steve and I were first sending our newsletter to a few pharmacists, we realized we needed to offer more than any other diabetes newsletter. We were the new kids on the block; we weren’t journalists, but we were pharmacists. So we started to look for well-respected, interesting medical professionals who could share some different insight and some new ideas on how to best take care of patients with diabetes.

This is how we met Dr Sheri Colberg. She was working at East Virginia Medical School and we were introduced to her by Dr. Aaron Vinik. Sheri, who won the American Diabetes Association’s 2016 Outstanding Educator in Diabetes Award, took a chance to work with us and I am happy to announce that this week her feature, Get off the Couch and Work Your Core, represents the 200th article she has prepared for us.

Please join me in congratulating her for reaching that milestone.

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We can make a difference!

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Dave Joffe

Editor-in-chief

Are you more likely to add a basal insulin to the treatment plan for a patient with type 2 on two oral meds with an A1c of 8% for 5 months, BMI of 30, or add another medication besides insulin?

More likely to add insulin
More likely to add another med besides insulin

Follow the link to share your opinion.

There  was a prospective study of the safety and accuracy of the Eversense continuous glucose monitoring (CGM) system for diabetes control in 90 adults with type 1 or type 2 diabetes. The authors observed a mean absolute relative difference against reference glucose values of 8.8%, and 93% of CGM values were within the prespecified 20% of reference values. The sensors remained functional through day 90 in 91% of cases.  The results indicate that the Eversense CGM system can safely and accurately measure glucose levels over the course of a 90-day interval.

• Sensor that lasts up to 180 days –  no weekly sensor insertion
• Water-resistant smart transmitter with on-body vibes alerts
• Readings on mobile app — no separate receiver
• Predictive alerts before reaching low or high glucose alert level
• Glucose readings automatically sent to app every 5 minutes
• Removable/rechargeable smart transmitter
• No sensor wasted when smart transmitter is removed
• Requires a minor 5-minute surgical procedure
• FDA approval in the U.S. expected early 2018

You are reviewing lifestyle modifications with a 42-year-old, relatively sedentary patient who has been newly diagnosed with prediabetes. Your screening for any cardiovascular risk factors was negative, so she has agreed to a 3-month trial of dietary modifications and increased physical activity. Structured exercise interventions and modest weight loss have been shown to lower the risk of developing type 2 diabetes in high-risk populations by an average of:

A. 22%
B. 35%
C. 58%
D. 70%

Follow the link for the answer.

In a new large study, the results suggest that children who are short compared to their peers are at greater risk for having a stroke later in life. For the study, they examined height measurements collected from age 7 to 13 for 311,009 school children born between 1930 and 1989. They followed half of the participants for at least 31 years, with the duration of follow-up ranging from 25 to 83 years. During the study, 10,412 people had an ischemic stroke and 2,546 had a hemorrhagic stroke.

People who were just two or three inches shorter than average for their age and sex during childhood had an increased stroke risk as adults. Lead authors added that previous data from the first half of the 20th century also linked short stature to an increased risk of stroke, which was thought to be due to factors like poor nutrition or childhood infections that might impact height. It was concluded that adult women who were unusually short girls at age 7 years were 11% more likely to have an ischemic stroke. Men who were short at age 7 were 10% more likely to have an ischemic stroke and 11% more likely to have a hemorrhagic stroke. What was notable was that, despite an increase in average childhood height during the study period in the second half of the 20th Century, which was most likely due to improved nutrition and better childhood living circumstances, the risk of stroke in shorter children did not diminish during this period, as we would have expected if these factors were the underlying cause of the increased risks of stroke. One element that was not looked at in this study is what difference would it have made if the child is not only shorter but has type 2 diabetes? From the conclusion, the researchers added that parents of short kids shouldn’t necessarily panic and assume a stroke is automatically in their child’s future, but they should take steps to tackle other risk factors for stroke as blood pressure and obesity.  Online February 15, 2018 in the journal Stroke.

Study shows importance of clinical consciousness and assistance with disease management in individuals who were diagnosed with type 2 diabetes prior to age 45.

Patch delivery system shows promise as a new developing treatment option for diabetes.

Low Fat-Vegetarian-Vegan diet shown to improve glucose control, slow diabetes progression.

New technology allows freedom from daily manual injections and oral antidiabetics.

A predictive detection system helps to reduce risk of low blood glucose.

By Sheri R. Colberg, PhD

If you suffer from diabetes, you already know that staying fit greatly benefits your health. Yet, many of the complications caused by diabetes can make it difficult to get the exercise you need; in fact, they can make a normal exercise routine difficult or even dangerous. For example, peripheral neuropathy (numbness in the feet caused by nerve damage) may affect your balance and put you at risk for a fall, or could lead to slow-healing ulcers that keep you inactive. On top of that, diabetes patients may have heart disease symptoms or vision problems that make getting up and going for a walk more risky than helpful.

Quote of the Week!

“Optimism is the faith that leads to achievement. Nothing can be done without hope and confidence.”

…Helen Keller

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

Lamija Zimic, Doctor of Pharmacy Candidate 2018, USF College of Pharmacy

Adrianna Jackson, Doctor of Pharmacy Candidate 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