Author: drmandyreece1

Recently, when working with a person with diabetes taking insulin, he and I discovered that the reason his glucose was not lowering with insulin therapy is he removed the first but not the second cap on the insulin pen needle. You might be tempted to think, “really, are you serious?” Yes, I am serious. The underlying reason for this happening is he was not taught how to use the insulin pen when he first began taking insulin. I reassured him that he was not the first nor the last for this happen, and to not feel bad as he simply did not know. Guidance on how to use insulin pens is key prior to the first dose.

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#guidance #education #insulin #pens

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Liraglutide (Victoza), GLP-1 receptor agonist, is known for its ability to lower cardiovascular risk in persons with type 2 diabetes who have blood glucose values consistently above target range and who at high risk for a cardiovascular event (i.e. heart attack). What exactly mediates this benefit? Buse and colleagues uncovered that this benefit most likely is mediated by hemoglobin A1c. Please click below for additional details on this exploratory analysis.

https://www.healio.com/endocrinology/diabetes/news/online/%7B09ebef6b-62b1-42d0-bbf0-3c2ed5e6b68c%7D/hba1c-likely-mediates-liraglutides-cv-benefit?M_BT=4557970002905

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#A1c #liraglutide #CV #benefit

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A recent study (AWARD 11) by Dr. Frias in adults with type 2 diabetes currently on metformin without achieving target glucose goals were assigned to dulaglutide 1.5 mg, dulaglutide 3 mg and dulaglutide 4.5 mg. A stepwise dose escalation every 4 weeks to doses of dulaglutide 1.5 mg, 3 mg or 4.5 mg was completed. Dulaglutide 3 mg and 4.5 mg produced greater improvements in glycemia and body weight reduction however only dulaglutide 4.5 mg was superior to dulaglutide 1.5 mg. The results are promising for higher doses of dulaglutide however time will tell whether FDA approves these higher doses. Please click on link below for additional details.

https://www.healio.com/endocrinology/diabetes/news/online/%7B52416ea4-897f-46b7-9c8c-982afa65b7d7%7D/higher-dose-dulaglutide-reduces-hba1c-body-weight-in-type-2-diabetes?M_BT=4557970002905&page=2

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#dulaglutide #AWARD11 #diabetes #medication

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If you are a person with type 1, caregiver or healthcare professional working with persons with type 1 diabetes, you know the amazing value that both JDRF and Beyond Type 1 provide for persons with Type 1 diabetes. These rock star organizations have joined forces in creation of an alliance to address coronavirus + diabetes. They have developed an informative website with proactive steps to minimize risk of exposure to coronavirus as well as taking care of your physical, emotional and mental health. Please click below to access this vital information. Thank you JDRF and Beyond Type 1.

CORONAVIRUS + DIABETES

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#coronavirus #diabetes #JDRF #beyondtype1 #alliance

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How exciting! Dapagliflozin (Farxiga) initially approved for treatment of type 2 diabetes now has an indication beyond its use in diabetes. FDA has given dapagliflozin an indication for heart failure with reduced ejection fraction (HFrEF) to reduce risk of cardiovascular death and hospitalization for heart failure. Please click below to read more details.

https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-type-heart-failure

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#heart #failure #indication #Farxiga #FDA

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Results from VERTIS CV (Evaluation of Ertugliflozin Efficacy and Safety Cardovascular Outcomes) trial were a bit disappointing. Erugliflozin (a SGLT-2 inhibitor) did meet the its primary endpoint of noninferiority for major adverse heart (cardiovascular) events compared to placebo in persons with type 2 diabetes and established (diagnosed) heart disease (bottom line: ertugliflozin does NOT increase risk for major adverse heart events). However, it did not achieve secondary endpoints in superiority compared to placebo for composite of CV (heart related) death or hospitalization for heart failure, CV (heart related) death alone, and renal (kidney related) death (bottom line: ertugliflozin does NOT decrease risk of CV (heart related) or renal (kidney related) death in a person with diabetes and established cardiovascular (heart) conditions).

https://www.medscape.com/viewarticle/929647

Because we know diabetes does not happen in a silo and is often associated with cardiovascular (heart) and renal (kidney) conditions, the ideal is to have a diabetes medication that provides also heart and kidney related benefits. Bottom line is that ertugliflozin does NOT provide these benefits.

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#ertugliflozin #diabetes #cardiovascular

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A panel of experts have provided guidance on appropriate care for persons with diabetes and COVID-19. No much difference in glucose targets. Worth noting that it is recommended to stop metformin and SGLT-2 inhibitors in persons with diabetes and COVID-19 due to increased risk for dehydration, acute kidney injury and chronic kidney disease. The guidance is worth a read (link provided below).

https://www.medscape.com/viewarticle/929558#vp_2

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#guidance #diabetes #COVID-19

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In general, many people are hesitate to go to hospital or medical offices during COVID-19 (and rightfully so) pandemic. However, it is important to keep in mind that new cases of diabetes are still occurring and require medical treatment. Type 1 diabetes may first be diagnosed when a child or adult experiences diabetic ketoacidosis (medical emergency). So please be aware of the following signs and symptoms, and do not confuse them with symptoms of a virus. If you have these symptoms, please seek medical attention (MedPageToday).

Going to toilet a lot or bed wetting by a child who has not previously been wetting the be

Being really thirsty and unable to quench thirst

Feeling more tired than usual

Unplanned weight loss or looking thinner than usual

https://www.medscape.com/viewarticle/929243

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#diabetes #symptoms #COVID-19

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We are living in unprecedented times globally. It is challenging to face fear head on each day. I have found rays of sunshine in this darkness through the following practices (and yes some days I do better than other days).

1. Journalling specifically writing 3 things for which I am grateful each day.
2. Calling or connecting virtually with a friend or family member at least 4 times weekly.
3. Taking a walk outside to see the flowers and listen to the birds.
4. Stay connected to my faith community virtually and prayer

Do these practices take away the reality of the challenges? No, they simply give a different perspective. I highly recommend a book on anxiety, Anxious for Nothing, by Max Lucado. Remember, the problem is how we think about our problem. Ponder on this one as I have been for the last few days. Don’t forget to make your daily gratitude list. Sending a virtual hug to each of you.

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#sunlight #COVID-19

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Good news to share! Novo Nordisk has joined Lilly in offering program assisting with cost of insulin in light of COVID-19. Novo Nordisk’s program offers 90 day supply of insulin at no charge to those who lost health coverage due to change in job status due to COVID-19. While I know that this is not a long term solution, it is a short term help for those who have lost health insurance. This program is much needed in these challenging times. To get all of the details, please go to NovoCare.com or call 1-844-668-6463. found on NovoCare.com or by calling 1.844.NOVO4ME (668.6463). Please share this information with all persons with diabetes on insulin therapy.

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#insulin #program #COVID-19

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