November 3, 2018 : Issue #962

• Possible Breakthrough In Treating Type 2 Diabetes and Prediabetes
• Sotagliflozin As Adjunct Therapy for People with Type 1 to Increase Time in Target Range
• Oral Semaglutide Shows Promise in HbA1c Reduction and Weight Loss
• Albiglutide’s Effect on Cardiovascular Outcomes in People with Type 2 Diabetes
• New (2018) ADA Position Statement for Type 1 Diabetes
• How the Diets Active Adults with Diabetes Follow Impact Their Performance
  • By Sheri R. Colberg, PhD, FACSM

For years the medical staff of Diabetes In Control have advocated a low-carbohydrate lifestyle for both diabetes care and weight management. Recently I have been working with the use of intermittent fasting featuring a lower carb focus. The results for both weight control and glucose control have been very, very good. However, we often hear comments from our colleagues who exercise extensively, that they are afraid eating low carb will leave them lacking for energy.

This week we have a great feature on intermittent fasting, and our Exercise Guru, Dr. Sheri Colberg, weighs in on the use of the low carb lifestyle and how her active patients have done.

*****************************

We can make a difference!

*****************************

Dave Joffe

Editor-in-chief

What is your top concern when prescribing SGLT-2 inhibitors to patients with diabetes?

– Amputation risk
– Infection risk
– Kidney risk
– Price

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

The FDA has approved the sodium-glucose cotransporter type 2 (SGLT2) inhibitor canagliflozin (Invokana, Janssen) to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes who have established cardiovascular disease (CVD). With FDA approval of the supplemental new drug application, canagliflozin becomes the first oral diabetes drug indicated to reduce the risk of myocardial infarction (MI), stroke, or death due to a cardiovascular cause. Empagliflozin (Jardiance, Boehringer Ingelheim/Lilly), another SGLT2 inhibitor, is allowed by the FDA to claim reduced cardiovascular mortality on its labeling.

The FDA has approved the FreeStyle® LibreLink mobile app for use with compatible iOS smartphones in the U.S. Now, Americans with diabetes using the FreeStyle Libre system can monitor their glucose directly on their compatible iPhone devices and will be available shortly in the App store.

This GLP-1 Agonist Medications Chart outlines the latest GLP-1 medications approved by the FDA for diabetes treatment and the differences and similarities between them. Print out this chart and post in your office as a handy reference for your staff and patients alike. The chart is in PDF format. Use this link to download: GLP-1 Agonist Medications Chart

Which of the following is an important consideration when giving a post-meal insulin bolus with the aid of CGM-based trend arrows dosing in order to avoid hypoglycemia in persons using multiple daily insulin therapy?

A. Always consider using the full dose suggested by calculations based on the correction factor and target glucose.
B. Give ~50% of the calculated insulin dose (using the correction factor and target glucose) to adjust for active insulin (insulin on board).
C. Use ~25% of the calculated insulin dose (using the correction factor and target glucose) to adjust for active insulin (insulin on board).
D. Use 75% of the calculated insulin dose (using the correction factor and target glucose) to adjust for active insulin (insulin on board).
E. Another insulin dose should never be given after eating.

Follow the link for the answer.

In a published study, researchers calculated the lifetime costs for medical treatment and care for those diagnosed with diabetes. For men diagnosed with type 2 diabetes at ages 25-44 years, 45-54 years, 55-64 years, and ≥ 65 years, the lifetime direct medical costs of treating type 2 diabetes and diabetes complications were $124,700, $106,200, $84,000, and $54,700, respectively. In women, the costs were $130,800, $110,400, $85,500, and $56,600, respectively. The age-gender weighted average of the lifetime medical costs was $85,200, of which 53% was due to treating diabetes complications. The cost of managing macrovascular complications accounted for 57% of the total complications cost. Over a lifetime, type 2 diabetes imposes a substantial economic burden on healthcare systems. Effective interventions that prevent or delay type 2 diabetes and diabetes complications might result in substantial long-term savings in healthcare costs.  — American Journal of Preventive Medicine

Free potential treatment lowers blood sugars, helps with weight loss, drops blood pressure and cholesterol, and may add at least 10 years of quality of life.

Researchers seek development of drug therapies and technologies to assist in achieving additional time in glucose target range and less hypoglycemia.

First oral GLP-1 agonist undergoing Phase 3 trials shows significant benefits managing type 2 diabetes.

Study looks at convenient once-weekly GLP-1 that can reduce chances of heart attacks and strokes.

Recommendations place special emphasis on youth newly diagnosed with diabetes.

By Sheri R. Colberg, PhD, FACSM As discussed in an earlier column this year (June 2018), many insulin users have chosen to go “low-carb” to better manage diabetes, which may or may not impact how well they perform in athletic events. How do many athletes with diabetes who swear by extreme low-carb diets that are …

Quote of the Week!

“Science is a beautiful gift to humanity; we should not distort it.”

…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:

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

Arsalan Hashmi, PharmD. Candidate, LECOM College of Pharmacy

Seema Badrbigi, PharmD Candidate

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