#51: Diabetes Treatment In 2017: New Meds, Insulin, And Cardiac Risk Reduction

#51: Diabetes treatment in 2017: New meds, insulin, and cardiac risk reduction

Get cozy with these new drugs for diabetes treatment. Don’t be scared, they won’t bite. On this episode, we interview Endocrinologist and current president of AACE, Dr. Jonathan D. Leffert, MD, FACP, FACE, ECNU about how to utilize the myriad of new diabetes drugs on the marketplace including SGLT2 inhibitors, DPP4 inhibitors, GLP1 agonists, and new ultra long acting insulins. Plus, we’ll teach you how to choose between agents, common side effects, A1C goals, and the cardiovascular benefits of these newer agents. Help patients afford their meds with this resource from AACE http://prescriptionhelp.aace.com
Full show notes available at http://thecurbsiders.com/podcast
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Case: Case from Kashlak Memorial Hospital: 49 yo M with HTN, BMI 29, hyperlipidemia, family history of premature CAD (dad age 45yo), and type 2 diabetes with A1C increase from 6.4% to 9% while on metformin monotherapy.
Clinical Pearls:
Latent autoimmune diabetes of aging (LADA): Autoimmune disease similar to type 1 diabetes (DM1). Suspect if older adult presents w/new insulin dependence. Check glutamic acid decarboxylase (GAD) antibodies, which are most sensitive and specific. Often positive in LADA/DM1. Can also check islet cell Ab or insulin autoantibodies.
A1C and anemia: Based on red cell (RBC) survival. Falsely high a1c if RBC turnover is low → Older RBCs that accumulate more glucose e.g. Iron, vitamin B12, or folate deficiency anemia. Falsely low a1c if rapid RBC turnover e. Continue reading

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Fresh Food By Prescription: This Health Care Firm Is Trimming Costs — And Waistlines

The advice to eat a healthy diet is not new. Back around 400 B.C., Hippocrates, the Greek doctor, had this missive: Let food be thy medicine.
But as a society, we've got a long way to go. About 1 out of every 2 deaths from heart disease, stroke and Type 2 diabetes in the U.S. is linked to a poor diet. That's about 1,000 deaths a day.
There are lots of places to lay the blame. Calories are cheap, and indulgent foods full of salt, sugar and fat are usually within our reach 24/7.
So, how best to turn this around? Consider Tom Shicowich's story. It begins with a toe. His left pinky toe.
"One day I looked down and it was a different color ... kind of blue," Shicowich says. And he began to feel sick. "I thought I was coming down with the flu."
The next day he was on the operating table. A surgeon amputated his toe, and it took two weeks of intravenous antibiotics to fend off the infection.
All told, he spent a month in the hospital and a rehab facility. "Oh, I tell you, it was a bad year," Shicowich recalls.
But this wasn't just bad luck. His toe emergency was somewhat predictable. Foot infections are a common complication of Type 2 diabetes — often due to nerve damage and poor blood flow, especially when the disease isn't well-controlled.
He racked up about $200,000 in medical charges from his toe emergency. The portion he had to pay out of pocket drained his savings account. "I did shell out $23,000 to the hospital, so that was a kick in the head," Shicowich tells us.
It was also a wake-up call.
Shicowich was more than 100 pounds overweight. He was was fighting nerve damage, Continue reading

Top Trump official says we shouldnt take care of someone who eats poorly and gets diabetes

Trumpcare: Giving you the freedom to purchase health insurance that covers nothing.
Mulvaneys statement was widely panned by progressives as compassionless, but diabetes advocates also noted that it is also inaccurate: The American Diabetes Association was quick to condemn Mulvaneys remarks, saying they are extremely disappointed and describing his statement as misinformed.
Mr. Mulvaneys comments perpetuate the stigma that one chooses to have diabetes based on his/her lifestyle, the statement read . We are also deeply troubled by his assertion that access to health care should be rationed or denied to anyone. All of the scientific evidence indicates that diabetes develops from a diverse set of risk factors, genetics being a primary cause. People with diabetes need access to affordable health care in order to effectively manage their disease and prevent dangerous and costly complications. Nobody should be denied coverage or charged more based on their health status.
All of the scientific evidence indicates that diabetes develops from a diverse set of risk factors, genetics being a primary cause. People with diabetes need access to affordable health care in order to effectively manage their disease and prevent dangerous and costly complications.
Indeed, poor diet and lack of exercise does not appear to have been the cause of diabetes for professional athletes who suffer from the disease, such U.S. soccer star Jordan Morris .
Whats more, Huffington Post health care reporter Jonathan Cohn pointed out that health care systems that attempt to segregate patients by medical Continue reading

Nottingham student with type 1 diabetes dies in his sleep | Daily Mail Online

Another friend Molly Ellison said: 'I am so lucky to have been able to call you my best friend as well as my housemate.
'So sad to see you go so soon, a day won't go by where I don't miss you and I'll always love you and remember you forever.'
Angela posted on Twitter: 'My lovely Egyptian friend Middo dabbing in memory of Tommy Green who lost his life this week to type 1 diabetes.'
Another poster Katie said: 'Sadly lost one of our family friends to type 1 diabetes. Share to show your support for Tommy.'
Caroline Smith posted a photo of her son's marine cadets troop 'dabbing' as a group.
She wrote on Facebook: 'My son Liam with Normandy Troop Plymouth 30 Royal Marine commando cadets xx (I have type 1 diabetes)'.
Hundreds of well-wishers have posted photos of themselves doing the now-famous 'dab' move
His friend Russell Edge posted: 'Tom was my very best friend - the kindest soul. We miss him every day'
Angela posted on Twitter: 'My lovely Egyptian friend Middo (left) dabbing in memory of Tommy Green who lost his life this week to type 1 diabetes' while a man in a ski lift (right) also took part
Caroline Smith posted a photo of her son's marine cadets troop 'dabbing' as a group
Sarah Jackson added: 'So sad, my heart goes out to Tommy's family. My Son was diagnosed with type 1 diabetes three years ago at the age of 12, so I will light a candle in memory of Tommy.'
Zoie Carter-Ingham said: 'Heartbreaking - my thoughts go out to his family. A candle for Tommy will be lit in my home tonight.'
Charlotte Summers, chief operating officer ofpatient forumDiabetes.co.uk, Continue reading

Okra for Diabetes and Weight Loss

http://www.1mhealthtips.com/okra-for-diabetes-and-weight-loss/
Okra is gaining a reputation as a popular superfood for people with or at risk of diabetes and in weight loss. Commonly referred to as ladyfingers, or by its biological names Hibiscus esculentus and Abelmoschus esculentus , okra is known to have a positive effect on blood sugar control, among its many health benefits.
Evidence of okra containing anti-diabetic properties has increased in recent years, with multiple Vivo (animal) and Vitro (laboratory) studies, confirming okra as a potent anti-diabetic and blood glucose-lowering food.
In a study, published in 2011 in the Journal of Pharmacy & BioAllied Sciences, researchers in India found that diabetic mice which were fed dried, ground okra peels and seeds experienced a reduction in their blood glucose levels, while others showed a slow decrease in blood glucose following regular feeding of okra extract for about 10 days.
Many individuals with diabetes have reported decreasing blood sugar levels after soaking okra pieces in water overnight and then consuming the juice in the morning.
One study indicates that fatigue levels and recovery times can be improved by use of the okra plant. By including okra in your diet plan along with a healthy exercise plan, you may be able to work out for longer and recover more quickly from your exercise.
Cardiovascular activity is an important part of preventing and treating diabetes. This means that the okra plant may contribute to a more active lifestyle.
Studies have proven that the seed extracts of okra have an anti-str Continue reading