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ADA has released an updated position statement on management of youth-onset Type 2 diabetes. Please click below learn more about this position statement.

http://care.diabetesjournals.org/content/early/2018/10/26/dci18-0052

 

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Updated cholesterol treatment guidelines from the American Heart Association and American College of Cardiology emphasize personal approach.  It is no longer one size fits.   Considerations such as family history, whether a person has diabetes and whether person is of an ethnicity considered to be at a higher risk must be assessed.  Click below to learn more details about these exciting new updated guidelines.

https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000624

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Celebrating World Diabetes Day!  I am wearing blue in honor of all those living with diabetes and prediabetes.  Join me in honoring these amazing people.

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It sure is nice if a diabetes medication has an additional benefit.  Now, there four diabetes medications that protect the heart….Victoza, Trulicity, Invokana and Jardiance.

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Do you love technology as much I do?  I recommend the FreeStyle Libre on daily basis to persons with diabetes as it makes glucose monitoring easy.  What has been missing an app to compliment this great technology.  The wait is now over.  So excited to have the 14 day sensor as well as the FreeStyle LibreLink app!   Make sure to download this app.

https://www.bloomberg.com/news/articles/2018-11-01/abbott-wins-fda-approval-of-much-anticipated-insulin-monitor-app

 

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Did you know that it is National Diabetes Educators Week?  What a great week to celebrate all diabetes educators who work tirelessly with persons with prediabetes and diabetes to empower them to have the best quality of life possible.   Click below to read about Jamillah (a diabetes educator) and her innovative practice.

https://www.diabeteseducator.org/news/member-update/july-2018/july-2018-details/forward/2018/07/10/july-2018-member-spotlight

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During clinic this morning, I had my second visit with a precious lady who has gestational diabetes. She was excited that the dietary changes were working to bring her glucose down. She had even persuaded her husband to eat healthy as well.  She also felt much better physically especially more energy.  She became disheartened when I shared that medication was needed to assist in bringing her glucose into target range.  She was shocked and confused.  How could this be?  She had lots of questions regarding effects of elevated glucose on her baby, and how the medication worked to lower her glucose.  I paused and stopped worrying about getting to the next patient.  I slowed down and allowed time needed to answer each of her questions.  After having her questions answered, she was relieved and understood why she needed the medication.  Now that is patient care.

 

 

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You are winding down from a fun Halloween evening, You are tempted to grab some candy from your child’s treasure of yummy treats or the left over candies.  Stop…before you do, click below to check the carb content.  Moderation is key. My favorite is candy corn. What is your favorite candy?

https://dlife.com/halloween-candy-carb-chart/

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Bill is one of my favorite patients as he is elderly gentlemen with a loving supportive family.  During his last visit with me, he shared his frustration of having the benefit of medical transportation to his dialysis appointments discontinued due to his “improved health.” As it turns Medicare discontinued this vital service for Bill because his health improved.  This is an issue because Bill also has dementia and can not remember how to get home from the dialysis center if he drives for his treatment.

 

While I am a diabetes educator, I have the responsibility and privilege of caring  for the “whole” person as in Bill’s scenario.  Good news, after following up with his PCP, the paperwork is being processed for Bill to get his medical transportation to dialysis center back.

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It is tempting at times to give up when hitting a brick wall.  Today, I celebrated breaking through the brick wall.

Meet Sally a senior adult with Type 2 diabetes that I have been working with and supporting her in managing her Type 2 diabetes.  I have felt like I keep hitting that “brick wall” with Sally.  Today would be different.

I reviewed Sally’s chart when I arrived at office this morning.  At her last office visit, her blood sugar was over 500 mg/dL. Oh no, I thought.  She had been closer to target range prior to that office visit.  What was happening?  When Sally arrived for her visit, I checked her blood sugar and reviewed her blood glucose log (most values in 300 – 499 mg/dL range).  Oh no!  I assessed her abdominal area for any fatty deposits (lipodystrophy).  No fatty deposits.  I asked her to demonstrate how she injected her insulin. Spot on, no issues with insulin administration.  So I ask her about her 500 mg/dL blood sugar during last office visit. She states, “I ate a tomato sandwich without taking my bolus insulin.”  Ummm.  Now, I honestly did not see how that would cause such a glucose elevation. Keep digging!  Keep digging!  After doing a diet recall with her, the pieces of the puzzle still do not fit.  Ummm…what about beverages?  She only drinks orange juice when her glucose is low.  Turns out, she loves to drink an old fashioned Coke Cola.  She enjoys drinking her coke most every day.  The culprit for the significant glucose elevation..an old fashioned coke. After a bit of discussing and bargaining, Sally agreed to limit her coke to only when she had a low glucose.  Often times, we must dig, dig and dig to discover the obvious.

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