Author: drmandyreece1

The Center for Disease Control (CDC) has lead the way in diabetes diabetes prevention particularly in developing the standards for diabetes prevention programs. The American Diabetes Association additionally has made got strides in their online diabetes screening tools. Lifestyle changes (nutritional and physical activity) are vital for diabetes prevention. I know this personally as I had prediabetes previously, made significant lifestyle changes and my glucose is within normal. I also know the struggle in making changes in nutrition and increasing physical activity. The recent findings from National Health Interview Survey for 2016 and 2017 found significant gaps in advice provision and referrals to diabetes prevention programs. Diabetes prevention programs are covered benefit of Medicare and many commercial insurance plans. Many state health departments also have diabetes prevention programs. To learn more about the survey results and diabetes prevention programs, please click below.

https://www.medscape.com/viewarticle/912929?src=wnl_edit_tpal&uac=293412PG&impID=1963955&faf=1

https://www.cdc.gov/diabetes/prevention/index.html

https://www.diabeteseducator.org/prevention

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#time #address #gaps #diabetes #prevention

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A rare potentially fatal infection of the perineum, fournier gangrene, is associated with sodium-glucose cotransporter-2 (SGLT-2) inhibitors. Dr. Bersoff-Matcha published a review of 55 cases reported to FDA Adverse Event Reporting System through January 2019. A SGLT-2 inhibitor class label warning for fournier gangrene has been in place since mid 2018. To learn about this review, please click below.

https://www.medscape.com/viewarticle/912634?src=wnl_edit_tpal&uac=293412PG&impID=1957647&faf=1#vp_1

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#infection #SGLT-2inhibtor

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Technology has transformed the face of diabetes care and the day to day of living with diabetes. Sharing data with family and caregivers is particularly important for pediatric patients. Freestyle Libre now has app, LibreLinkUp (for iPhone, iPad, iPod touch), that provides remote monitoring. Caregiver can specifically see the current value and trend. Unfortunately, this app is not available for Android devices. To learn more, please click below.

https://diatribe.org/scan-freestyle-libre-cgm-sensor-your-iphone-freestyle-librelink-and-librelinkup-apps-available-us?utm_source=diaTribe&utm_campaign=0312777827-EMAIL_CAMPAIGN_2019_04_29_08_19&utm_medium=email&utm_term=0_22467a8528-0312777827-152660205

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#freestyle #LibreLinkUp #remote #monitoring

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Who would have thought? An anti-malarial medication having potential as adjunctive treatment of type 2 diabetes. Yes, hydroxychloroquine (Plaquenil) provided similar hemoglobin A1c reduction as canagliflozin when added to vildagliptin and metformin in persons with diabetes unable to achieve glycemic goals. To learn more, please click on link below.

https://www.medpagetoday.com/meetingcoverage/aace/79487?xid=nl_mpt_SREndocrinology_2019-04-30&eun=g1137305d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=EndoUpdate_043019&utm_term=NL_Spec_Endocrinology_Update_Active

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#hydroxycholoroquine #adjunctive # treatment #type2diabetes

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Historically we have been limited to metformin and/or insulin in adolescents and children with Type 2 diabetes. Unfortunately, metformin alone is often not enough to maintain control of glucose long term in children and adolescents with Type 2 diabetes. In recently published 52 week study, metformin with liraglutide reduced both hemoglobin A1c (primary outcome) and fasting glucose (secondary outcome) as compared to increase in hemoglobin A1c and fasting glucose with metformin alone. We can conclude that daily liraglutide with metformin does improve control of glucose over one year. To learn more, please click below.

https://www.nejm.org/doi/full/10.1056/NEJMoa1903822?query=main_nav_lg

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#liraglutide #youth #type2diabetes

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Recently, Dr. Akshay Jain wrote an excellent article on how to guide persons with diabetes through fasting and feasting associated with Ramadan. He did an excellent job providing tips to avoid hypo- and hyperglycemia during this holiday. I highly encourage you to read this most useful article.

https://www.medscape.com/viewarticle/911752

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#altered #eating #tips

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Much emphasis has been placed on cardiovascular benefits associated with particular diabetes medications. Until now, data supporting renal benefits of specific diabetes medications has been absent. CREDENCE trial which enrolled persons with diabetes and chronic kidney disease produced results revealing positive renal benefits of canagliflozin. Persons enrolled in the study were on a stable dose of medication blocking renin-angiotensin system. Positive results were also found in terms of cardiovascular outcomes. Interestingly no increased risk of amputation with canagliflozin was found in this study. Potential for novel renal indication can be anticipated for canagliflozin in the future. To learn more about this game changing study, please click below.

https://www.nejm.org/doi/full/10.1056/NEJMoa1811744

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#canagliflozin #renal #cardiovascular #benefits

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When it comes to diabetes, one size does not fit all. So it only makes sense that nutrition and eating for persons with diabetes is not one size fits all. The ADA has released updated nutrition recommendations. Most importantly, it is clear all persons with type 1 and 2 diabetes should be referred for medical nutrition therapy – a refresher on medical nutrition is so helpful. It only makes sense that these recommendations encourage non-starchy veggies, eating whole foods, limiting sugar intake and gives green light for low carb eating — some essentials for healthy eating. Assessing current dietary habits then customizing guidance on carbohydrate to achieve glycemic targets is key.

To learn more, please click on link below.

http://care.diabetesjournals.org/content/42/5/731

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#updated #diabetes #nutrition #recommendations

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Exciting to share a new tool for weight loss! We now have a new novel capsule (Gelesis100, Plenity) that is FDA has approved for weight loss in combination with diet and exercise in those with body mass index greater than or equal to 25%. The capsule contains hydrogel particles that expand in stomach without systemic absorption. When taken twice daily before meals, it makes the person feel full. To learn more, please click below.

https://www.businesswire.com/news/home/20190414005031/en/Gelesis-Granted-FDA-Clearance-Market-PLENITY%E2%84%A2-%E2%80%94

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#weight #loss #tool #capsule

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Are apps designed for those living with type 2 diabetes all they have cracked to be? While carefully selecting the particular app that a person with type 2 diabetes uses is key, integrating real time support and situation specific (i.e. hypoglycemia) education is key. The analysis by Dr. Car published in JAMA found many apps designed for persons living with type 2 diabetes to lack real time support and situation specific education. It is important to note that apps associated with continuous glucose monitoring were not included in the analysis. One potential action step for improvement is to have more clinicians involved in the development of the apps allowing for evidence based support and education. To learn more about this study, please click below.

https://www.medscape.com/viewarticle/911855

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#apps #type2 #diabetes

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