Practical information about medications for people living with diabetes.
Author: drmandyreece1
Hi, I'm Mandy. I am a pharmacist and certified diabetes educator. I love working with patients with diabetes with the goal of empowering people living with diabetes to have the best quality of life.
Recently, I was asked when is the best time of day to take metformin immediate release and extended release. Taking metformin immediate release with first and last meal of the day – 10 – 12 hours between doses is ideal. Taking metformin immediate release with food can decrease the stomach upset. Metformin extended release is best taken in the evening as it works overnight to prevent the excess release of glucose from the liver.
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#metformin #timing #doses #diabetes
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Great news! FDA has approved liraglutide (Victoza) (GLP-1 agonist) is now approved for person age 10 and older with type 2 diabetes. This is exciting because there are limited medications (metformin and insulin (usually basal)) indicated for type 2 diabetes in adolescents. Please share with others.
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#Victoza #FDA #adolescents #type2diabetes
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Qternmet XR (AstraZeneca) has been FDA approved as oral adjunct treatment to diet and exercise in type 2 diabetes as adjunct in U.S. It contains dapagliflozin (SGLT2-inhibitor), saxagliptin (DPP-IV inhibitor) and metformin hydrochloride. This is an ideal combination in terms of the variety of drug mechanisms of action involved. To learn more, please click below.
As you may already know, ADA Standards of Care are now the living standards which basically means updates are made in real time rather than once year. CREDENCE trial results revealed that the SGLT-2 inhibitor, canagliflozin, was associated with both reduced renal failure and cardiovascular events in persons with type 2 diabetes and chronic kidney disease. These are game changing results. Updates to sections 10 and 11 of the ADA Standards of Care have been made as a result of CREDENCE trial findings. A few highlights of the updates include…
At least annual assessment of urinary albumin and estimated glomerular filtration (eGFR) rate in all persons with type 2 diabetes.
GLP-1 agonist medication may lower risk for albuminuria risk progression and/or CV risk in persons with CKD at elevated risk of CV events.
SGLT-2 inhibitor should be considered when eGFR is at or above 30 in persons with type 2 diabetes and chronic kidney disease especially with albuminuria above 300 mg/g to lower CV and renal risk.
Dr. Gordin and fellow researchers with Joslin Diabetes Center have published their findings on enzymes, pyruvaste kinase M2 (PKM2) and amyloid precursor protein (APP), which potentially protect against kidney disease in those living with Type 1 diabetes. To learn more about these very interesting findings, please click below.
Much work has been put forth by Centers for Disease Control, American Association of Diabetes Educators and American Diabetes Association in diabetes awareness and prevention. It looks as though this hard work has paid off. Recent analysis of data (1980 – 2017) from National Health Interview Survey reveals a decline in new diabetes cases. To learn more about these interesting findings, please click below.
Obesity does not occur in a solo. The updated obesity algorithm from Obesity Medicine Association which has been recently released highlights the comprehensive care for obesity. The algorithm incorporates care for cardiovascular disease, diabetes and cancer. Please take a few moments to review the updated algorithm by clicking on links below.
Senseonics has created a patient assistance program (Eversense Bridge Program)for its implantable CGM, Eversense. This program reduces the cost to $99 plus cost for sensor insertion and removal (this process has to be completed in healthcare providers office). To be qualify, you must be at least 18 years old, not have any federal or state funded health insurance plan, have prescription for Eversense, not have full coverage for Eversense with your insurance or not resident of Massachusetts. To learn about this assistance program, please click below.
Insulin lispro, generic Humalog, is now available in pharmacies. It is half the list price of Humalog at a list price of $137.50 per vial and $265.20 for a package of five KwikPens. It is interchangeable so pharmacists can substitute it for Humalog without a new prescription. The target population is those who are under- or uninsured, and those in Medicare Part D coverage gap.
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#insulin #generic #Humalog
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The needs of a person living with diabetes changes through the various transitions of life so the specific needs for self management and support. There is no cookie cutter. Federal legislation, HR 1840 and S 8143, expands the current diabetes self management training that is covered by Medicare. How does it do this?
Allows the initial 10 hours of DSMT during first year after diagnosis of diabetes to remain available until fully utilized. Life happens and it may not always be possible to utilize the 10 hours of training the first year.
Increases the hours of DSMT from 2 to 6 hours in subsequent years.
Allows DSMT and Medical Nutrition Therapy (MNT) to be provided on same day as currently they can not be provided on same day.
Excludes DSMT from Medicare Part B cost sharing and deductible requirements.
Permits physicians and non-physician practitioners who are not directly involved in managing an individual’s diabetes to refer them to DSMT services. For example, with this expansion, an emergency room provider could refer a person for diabetes education.
Allows DSMT to be provided in a community based location (i.e. community center, churches, etc). Meeting people where they are.
Establishes a 2 year demonstration of virtual DSMT. It is not always feasible for various reasons for a person to travel to a diabetes education center.
Whether you are a person living with diabetes, a caregiver, diabetes educator or healthcare professional, please contact your Congressman and Senators, and ask them to co-sponsor HR 1840 and S 814. Diabetes is a bipartisan issue.
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#diabetes #AADEAdvocacy
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