October 20, 2018 : Issue #960

• Childhood Diabetes Lowers Lifespan by 18 Years
• Dapagliflozin Use in Managing Type 1 Diabetes
• Comparison of Semaglutide versus Liraglutide for Weight Loss in Patients with Obesity
• Safety and Efficacy of Lorcaserin
• Biomarkers to Predict Cardiovascular Events in People with Type 2 Diabetes
• Inhaled Vs. Injected Insulin

Over the years we have had many articles, features and interviews on medications and how good they are and how combination and/or long acting products seem to have better outcomes. In addition, when pharma companies compare their drugs to others they are often looking for “best in class” designation, and this is based on patents taking their medications every day. I wonder, if a particular medication lowers BG levels 10% more than another drug in the same class and the patient only takes it 6 days a week, does that negate the best in class value?

Since we know patient persistence is important with diabetes medications, the easier we can make it for our patients the better it is. This is why the weekly GLP-1 Analogs serve our patients well.

This week our Pharm D intern, Angela Reyes, has the results of a study comparing daily and weekly GLP-1 analogs for improving patient outcomes.

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We can make a difference!

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Dave Joffe

Editor-in-chief

Your patient has been checking their blood glucose after a meal and then using the reading to correct with insulin. What do you do?

– Wait 3 hours since their last injection of rapid insulin
– Wait 4 hours
– Wait 5 hours
– Wait 6 or more hours
– Have them use a calculation to adjust for onboard insulin, then use that in their calculation to correct

Follow the link to respond.

Abbott Freestyle Libre 14-day sensors will be available on October 22nd and  the “per day” cost will remain in the same range; at this time, Abbott will continue to make the original FreeStyle Libre sensors available.  The Freestyle Libre CGM will also be offering Real Time Alert alarms soon.

KingFit is a mobile diabetes education app that features educational content from world-renowned diabetes educators to the palm of your hand. Unlike other diabetes apps, KingFit is the only solution that allows you to press two buttons to start learning from a certified diabetes educator for free.

Which of the following is true regarding the presentation and diagnosis of hypertriglyceridemia?

A. Hypertriglyceridemia is usually asymptomatic until triglyceride levels are greater than 500-900 mg/dL.
B. When triglycerides are elevated, blood glucose and A1c should be checked to rule out uncontrolled diabetes.
C. Second-degree relatives should be screened for hyperlipidemia.
D. The use of oral contraceptives, beta-blockers, and thiazide diuretics have been linked to decreased plasma triglyceride and very low-density lipoprotein (VLDL) levels.

Follow the link for the answer.

Insulin prices far outweigh product costs. The cost to make a vial of human insulin is $2.28 to $3.42, and a vial of most analog insulins costs $3.69 to $6.16 to produce.  In a current study in BMJ Global Health, after analyzing expenses for ingredients, production, and delivery, among other things, the researchers contend that the price for a year’s supply of human insulin could be $48 to $71 per person and between $78 and $133 for analog insulins, which are genetically altered forms that are known as rapid- or long-acting treatments. Examples of analog insulins include Humalog, Lantus, and Novolog. The question comes up,  how can pharmaceutical companies justify charging on average more than a thousand dollars a year? Just as the cost for blood glucose strips have come down significantly after the process was opened up to a bidding process, or maybe prevent rebates to managed care organizations and PBM’s for putting certain brands on their formularies. As medical professionals, we need to participate in getting the cost down for insulin which is required to live. — JAMA. 2016;315(13):1400-1402. doi:10.1001/jama.2016.0126 BMJ Global Health.

Researchers suggest implementation of cardioprotective medications sooner than current guideline recommendations.

Adding an SGLT2 inhibitor helps lower HbA1c and decrease variability in glucose ranges among people with type 1 diabetes.

Researchers study efficacy and safety of GLP-1 inhibitors on weight loss.

New study focuses on cardiovascular safety of weight loss drug in patients with excess weight or obesity.

The SUMMIT VIP study shows conventional risk factors do not suffice in predicting heart complications.

A study tests postprandial inhaled glucose for a more natural insulin effect.

Quote of the Week!

“If you want to shine like a sun, first burn like a sun.”

…A.P.J. Abdul Kalam

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

Melissa Bailey, Pharm.D. Candidate, USF College of Pharmacy

Angela Reyes, Pharm.D. Candidate, LECOM College of Pharmacy

Arsalan Hashmi, PharmD. Candidate, LECOM College of Pharmacy

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