November 10, 2018 : Issue #963

• • GLP-1/GIP Drug Shows Promise in Reducing A1c and Reducing Weight
  • SGLT-2i Use in Type 1 Diabetes May Help Maintain Glycemic Levels
  • New-Generation Automated Insulin Delivery System for Youth with Type 1
  • Breakthrough In Insulin Pricing
  • Better Glucose Management in Gestational Diabetes Has No Significant Benefit
  • Controlling Dementia Risk for People Who Have Type 1 Diabetes

Now that the Mid-term elections are, for all purposes, over with, we all know that there has been a change in leadership in the Congress. High on Congress’s agenda is the high cost of prescription drug prices, and we expect to see some pressure from the House to lower these costs. This could be great news for our patients who take insulin, as the price of insulin has skyrocketed over the past 10 years.

We know that the government sometimes moves slowly to make changes, but it appears that Sanofi may have a solution that our patients can take advantage of now! They are expanding their Insulin VALyou Savings program to include more patients. Check out Item #4 to see which of your patients can benefit.

Hopefully this will be the start of a trend that other insulin manufacturers will follow.

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We can make a difference!

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Dave Joffe

Editor-in-chief

If you could have any A1c result for yourself what would that be?

– Below 8%
– Below 7%
– Below 6%
– Below 5%

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

See Item #4.

Featuring 700 meal-planning options that are healthy, tasty, and nutritious for people living with diabetes, the American Diabetes Association (ADA) has launched Diabetes Food Hub™, a new digital cooking and recipe destination to help people living with diabetes and their families eat healthfully. Users can customize their search by cuisine types such as comfort food, Mediterranean, Southwest, and more, as well as filter by preferences such as low-carb, low-sodium, vegetarian, budget-friendly, or gluten-free. By creating a free profile, users can also enjoy a personalized experience, as the site learns likes and dislikes over time and offers suggestions based on past user preferences. Users can drag-and-drop recipes into a weekly Meal Planner, which automatically calculates nutrition information, and create an editable shopping list, organized by grocery store department to make your shopping trip easier. Nutrition Facts are available for all recipes, including total carbohydrates, calories, fat, and protein. Values for sodium, potassium, and phosphorus are also available to help users track their intake and create a meal plan suitable for blood glucose management, kidney disease, heart disease, or other health conditions. Diabetes Food Hub allows users to create personalized diabetes meals based on nutrition criteria they have developed with their diabetes care team. Explore the interactive site and healthy recipes and resources available on the Diabetes Food Hub at www.diabetesfoodhub.org.

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.

In previous studies, it was shown that diabetes mellitus is associated with impaired semen parameters. Men who are infertile and have prediabetes showed lower testosterone, sex hormone-binding globulin levels nuclear DNA fragmentation rates, and chromatin quality. Very little is known about the same association with prediabetes. Prediabetes is a common and underdiagnosed clinical condition that can be considered a red flag for further metabolic and cardiovascular diseases. Writing in BJU International, researchers reported elevated median hormonal markers among infertile men, including follicle-stimulating hormone (FSH) and 17β-estradiol, compared with infertile men without prediabetes. In addition, medians for several other hormonal markers were significantly lower among infertile men with prediabetes compared with infertile men who had normal glucose levels. Despite similar sperm concentrations and semen volumes between the two groups, significantly more men with prediabetes also had sperm DNA fragmentation over the threshold of 30% (58.4% prediabetes versus 41.8%, P=0.005), the researchers reported. From the results of the study, it was determined that prediabetes among men might be related to infertility, therefore it is recommended that clinicians assess glucose levels in male patients with infertility problems and recognize the clinical importance of prediabetes. By identifying prediabetes early, this will allow the possible countermeasures to be taken as early as possible in relatively young persons.

Reference:

Boeri L, et al “Undiagnosed prediabetes is highly prevalent in primary infertile men – results from a cross-sectional study” BJU Int 2018; DOI: 10.1111/bju.14558.

New combination drug has better efficacy in glucose control and weight loss than when taken separately.

Empagliflozin shows improvements in A1C while also having major adverse effects, but there could be a balance.

Study tests new closed-loop control technology using new Control-IQ algorithm.

With pressure from patients, elected representatives and the medical community, we are finally seeing some positive results in lowering the cost of a life-sustaining drug.

Current and less-strict ADA recommendations found to achieve appropriate glycemic levels.

Dementia rates are higher among people who have type 1 diabetes and an A1C greater than 8%,

Quote of the Week!

“Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow.”

….Melody Beattie

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

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