Resources

In this week's Homerun Slides, potential new treatment guidelines inspired by beta-cell-centric classification of diabetes.

Glucose regulation of insulin gene transcription factors: Pdx-1 is mainly localized at the nuclear periphery at low glucose concentrations (1–2mM) in beta cells, and becomes phosphorylated and shuttles into the nucleus in response to concentrations stimulating insulin secretion.

Very low calorie diets and probiotics can not only help in improving blood glucose for those with diabetes, but also help to prevent the development of diabetes.

Reduce the dose of sulphonylureas when adding DPP-4 inhibitor treatment in patients with type 2 diabetes, study warns.

Age-adjusted hospitalization rates for acute MI and stroke on the rise as more people are diagnosed with diabetes and prediabetes.

According to a BMJ study, men with prediabetes who increased their physical activity levels and women with prediabetes who reduced their waist circumference had lower risks of progressing to diabetes.

Current use of selective serotonin reuptake inhibitors was associated with a 23.3% risk of 30-day stroke mortality among diabetes patients hospitalized for stroke, compared with a 15.8% risk among those who didn't take the drugs.

Do you feel comfortable recommending an SGLT-2 Inhibitor drug to your patients? Follow the link to share your opinion and see what others think!

Using a continuous glucose monitor helps those with prediabetes and type 2 diabetes to self-regulate their exercise.

Mr. Fontello is an overweight, Caucasian 63-year old patient who comes in for a 6-month check-up. He has a 12-year history of type 2 diabetes. He was diagnosed at age 33 with high blood pressure, but had never really done much about it as it was “too much of a hassle” and he felt “just fine.” At the time his diabetes was diagnosed, he was referred to a diabetes education program and was started on metformin, lovastatin, losartan and aspirin. He has an individualized A1C goal of 7%. Four years after diagnosis, pioglitazone was added to Mr. Fontello’s diabetes regimen. Three years ago, he came in for an appointment complaining of polyuria, polydipsia and fatigue with an office A1C of 9.3%. At that time he was started nightly basal insulin detemir. Since that time, he has made concerted efforts to eat a healthy diet and get to the gym. Today, he reports his SBGM fasting plasma glucose levels are on target (FPG below 130mg/dL). He also states that his feet always feel a little bit swollen. BP 128/78, HR 73, RR 19. Physical exam is remarkable for peripheral edema and mildly decreased pedal pulses. Current medications: metformin, pioglitazone, insulin detemir, lovastatin, losartan, aspirin. At today’s visit, his office A1C is 8.1%. What changes would you recommend for his antihyperglycemic regimen? Select one answer: [A] Add a premixed insulin to all three meals of the day [B] Increase his detemir dose [C] Add a sulfonylurea to his regimen [D] Add a rapid-acting insulin analogue to his largest meal of the day Are you right? Follow the link to find out!