June 9, 2018 : Issue #941

• Beware: White Coat Hypertension Can Increase Risk of Death by 80%
• Current Screening Criteria Misses 50% of Those with Diabetes and Prediabetes
• Prevent Diabetes With Intermittent Fasting?
• Do SGLT2 Inhibitors Increase the Risk of Acute Kidney Injury?
• Housing Instability and its Impact on Hospital Resource Utilization

We have an interesting article and interview on the value of intermittent fasting and how this technique may prevent diabetes. Most professionals, myself included, felt that patients lost weight and had better glucose levels because theyate less. But I have some first hand evidence that matches up with what you will read in the article.

My 6’4” daughter manages the best rated gelato shop in Tampa Bay, and so you can guess she is exposed to a lot of temptation. She has kept her weight in check by eating low carb and cycling, but the pounds would creep on as it would be so hard for her to resist the gelato and coffee drinks at work. She decided to go on an intermittent fast, only eating for a 4 hour period every day. She tried to stay with strictly healthy foods but it was impossible, and she constantly had an urge to cheat.

After reading a few articles she made a change in her fasting. Her change was to eat whatever she wanted during the 4 hour window. This meant she could have anything and everything without regard to the amount of calories, carbs or sugar she consumed.

Believe it or not this worked. It seemed that having no boundaries during that time tremendously lessened her desire to cheat, and her cravings for food began to disappear. She was able to take off 28 pounds and has not had much problem sticking with the program.

After you read the article and then watch the Mark Mattson videos you may find this is a workable concept for some of your patients.

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We can make a difference!

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Dave Joffe

Editor-in-chief

Are you seeing more children with type 2 diabetes in your practice?

Follow the link to share your response.

If approved, Zynquista (sotagliflozin) will be the first oral drug approved in the U.S. that blocks both SGLT-1 and SGLT-2 and would be just the second drug since insulin to be approved for T1D as a potential treatment. Zynquista is meant to be used in addition to insulin therapy. The drug is an oral dual inhibitor of SGLT-1 and SGLT-2 proteins known to affect how the intestines and kidneys absorb and eliminate glucose. This blockage of proteins is expected to result in improved glucose control and other clinical benefits.

Tobacco use is a well-established single most important preventable cause of disease and death. Healthcare providers are well-positioned to treat cigarette smoking and nicotine dependence among their patients. Unfortunately, not every physician, physician assistant, or nurse have sufficient time to provide extensive counseling and treatment during patient visits. QuitMedKit© is designed to assist healthcare providers in effective counseling and treatment of tobacco dependence among their patients. This program provides state-of-the-art knowledge on behavioral counseling and pharmacological treatments for nicotine dependence.

After four years of good glycemic control with metformin 1500 mg a day, Mrs. Hunter returns for her 6-month follow-up visit. At this time, her office A1C is 8.2% and she has gained seven pounds. She is very concerned about her weight gain. If weight is a concern, what would be the best antiglycemic drug to add to her regimen?

A. A sulfonylurea
B. A DPP-4 inhibitor
C. A thiazolidinedione
D. A GLP-1 receptor agonist

Follow the link for the answer.

A new study with 400 participants, which was documented in the journal Sleep Medicine, showed that patients with type 2 diabetes who slept for six hours or more at night and napped during the day had better blood glucose control than those who slept for less than five hours with no nap. Data was collected on how long they slept for and when, the quality of their sleep, whether they woke during the night and any daytime naps they had. The research team also carried out blood tests to measure the participants’ HbA1c levels.  Researchers evaluated those patients with type 2 diabetes or impaired glucose tolerance and found that poor sleep patterns were associated with poor blood glucose control in type 2 diabetes, but for those whose nighttime sleep duration is short, a midday nap may be beneficial. The researchers concluded: “Midday naps may be harmful to many health status parameters in long night-time sleepers, but in short night-time sleepers, midday naps may have protective effects in specific circumstances.” — Sleep Medicine May 2018

Elevated BP readings at the doctor’s office linked to higher mortality than for those with consistently normal blood pressure.

Use of expanded criteria thought best way to detect widest population with abnormal blood glucose levels.

It can improve insulin sensitivity, pancreatic response to blood sugars, and even prevent prediabetes from turning into diabetes.

2016 FDA warning conflicts with recent evidence showing no increased risk following use of treatment.

ADA Guidelines highlight importance of social stability in diabetes management.

Quote of the Week!

“A champion is someone who gets up when he can’t.”

…Jack Dempsey

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

Kaytie A. Weierstahl, Pharm.D. Candidate, LECOM School of Pharmacy

Your Friends in Diabetes Care
Steve and Dave
Diabetes In Control
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Ewing, NJ, 08628
USA
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