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 Clinical Diabetes Current IssueСб, 15 янв

1. Timely News and Notes for Primary Care Providers from the American Diabetes AssociationСб, 01 янв[−]
Нет описания

2. Blame and Shame: The Stigma of DiabetesСб, 01 янв[−]
When my 8-year-old daughter developed diabetes, she felt isolated and confused. She questioned why she had developed this condition and why she was different from her peers. She wondered whether she was to blame for getting diabetes. It wasn’t until another child at her school received the same diagnosis that she could share her experiences and lose the sense of shame she experienced whenever she needed an injection, had an episode of hypoglycemia, or had to count her carbohydrates. Both type 1 and type 2 diabetes are stigmatized, yet type 1 diabetes is different. No one blames people with type 1 diabetes for their disease. Although the etiology is obscure, it certainly isn’t their fault. Still, the diagnosis carries its own forms of stigma in terms of ignorance and stereotyping.

3. Good to Know: ADA’s Standards of Medical Care in DiabetesСб, 01 янв[−]
Guidelines from the American Diabetes Association (ADA) describe what should happen with your diabetes care throughout the year. These guidelines are called the Standards of Care. They list what you and your doctor need to do to take care of your diabetes. For example, some things, such as your blood pressure, should be checked every time you see your doctor. Other things, such as a dilated eye exam, should be done once a year.

4. Standards of Medical Care in Diabetes—2022 Abridged for Primary Care ProvidersСб, 01 янв[−]
The American Diabetes Association’s (ADA’s) Standards of Medical Care in Diabetes (the Standards) is updated and published annually in a supplement to the January issue of Diabetes Care. The Standards are developed by the ADA’s multidisciplinary Professional Practice Committee, which comprises expert diabetes health care professionals. The Standards include the most current evidence-based recommendations for diagnosing and treating adults and children with all forms of diabetes. ADA’s grading system uses A, B, C, or E to show the evidence level that supports each recommendation.

5. Practicable Measurement and Identification of OverbasalizationСб, 01 янв[−]
In the March 2020 issue of Clinical Diabetes, our Practical Pointers article (1) outlined a definition for overbasalization as the titration of basal insulin beyond an appropriate dose in an attempt to achieve glycemic targets. Although there is consensus in this general definition, it does not offer clinicians a practicable marker to identify overbasalization. Indeed, the only clear-cut case of overbasalization would be an increase in the basal insulin dose of a patient with controlled fasting plasma glucose (FPG) to treat postprandial hyperglycemia. As we expect such an event to be uncommon, why, then, is overbasalization a growing concern?

6. Do-It-Yourself Diabetes Management: Perspectives of a Patient, a Physician, and an EthicistСб, 01 янв[−]
Evolving patient empowerment and education have produced communities of do-it-yourself (DIY) medical device makers and hackers who value their autonomy and, in at least some cases, achieve excellent results. Physicians may find themselves left out of what was once a cornerstone of an ancient and traditional relationship.

7. Weight Stigma and Diabetes Stigma: Implications for Weight-Related Health Behaviors in Adults With Type 2 DiabetesСб, 01 янв[−]
There has been little recognition that people with type 2 diabetes are vulnerable to weight stigma and diabetes stigma and almost no research examining the implications of these forms of stigma for their health and well-being. This study examined health behavior correlates of weight stigma and diabetes stigma in 1,227 adults with type 2 diabetes. Results showed that experiencing weight stigma in health care, experiencing differential treatment from others because of their diabetes, and engaging in self-stigma for diabetes and body weight were each significantly associated with increased frequency of binge eating and eating as a coping strategy to deal with negative feelings. Internalizing weight stigma was also significantly associated with lower levels of physical activity and worse self-rated health. These findings suggest that initiatives to improve the health and well-being of people with type 2 diabetes must consider the potentially harmful roles of weight stigma and diabetes stigma.

8. Worsening of Glycemic Control in a Patient With Fulminant Type 1 Diabetes Receiving Sensor-Augmented Pump Therapy: A Case of Extensive Localized Lipoatrophy Requiring Attention in Relation to Cannula Insertion SitesСб, 01 янв[−]
Нет описания

9. A Comprehensive System for Identifying Patients With Type 1 Diabetes at Increased Risk for Diabetic Ketoacidosis at Texas Children’s HospitalСб, 01 янв[−]
Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes. The following article describes a project at Texas Children’s Hospital aimed at improving identification of patients with type 1 diabetes at high risk for diabetic ketoacidosis.

10. Linagliptin-Induced ArthralgiaСб, 01 янв[−]
Нет описания

11. CRS Diabetes: An Effective Model for Improving Family Medicine Resident Knowledge, Competence, and Performance in Diabetes CareСб, 01 янв[−]
The Chief Residents Summit on Intensifying Diabetes Management, now in its 15th year, has resulted in real-world improvements in patient outcomes and has shown itself to be an effective model for teaching diabetes to family medicine residents. This article describes the program and the evidence supporting its effectiveness.

12. Understanding Gestational Diabetes, Future Diabetes Risk, and Diabetes Prevention: A Qualitative Study of Patient, Provider, and Staff PerspectivesСб, 01 янв[−]
Gestational diabetes mellitus (GDM) increases type 2 diabetes risk; however, postpartum diabetes screening rates are low. Using semi-structured interviews and focus groups, this study investigates the understanding of GDM and its relationship to future diabetes risk and diabetes prevention among patients with public or no insurance (n= 36), health care providers (n= 21), and clinic staff (n= 9) from Federally Qualified Health Centers. Five main themes emerged: 1) general understanding of GDM diagnosis with focus on neonatal complications; 2) variable recall of diet, exercise, and weight recommendations; 3) overwhelming medication and self-monitoring routines; 4) short-term focus of type 2 diabetes risk and screening; and 5) limited understanding of all options for diabetes prevention. The results may inform diabetes screening and prevention interventions in primary care settings.

13. Autoantibody-Negative Insulinopenic Diabetes Manifested After SARS-CoV-2 Infection: Two Cases With 9 Months of Follow-UpСб, 01 янв[−]
Нет описания

14. Recommendations for Practical Use of Metformin, a Central Pharmacological Therapy in Type 2 DiabetesСб, 01 янв[−]
Metformin is a biguanide derived from the plant Galega officinalis. Originally synthesized nearly 100 years ago in 1922 (1), it has been used in humans for more than 60 years (2). Interestingly, and despite its long history, the mechanism of action of metformin is not well understood (2). A decrease in hepatic neoglycogenesis has been the most frequently highlighted action (3,4). Metformin can influence AMP-activated protein kinase and the fructose-1,6-bisphosphatase pathway, leading to a decrease in the AMP/ATP ratio and reducing the energy available for neoglycogenesis (4). Recently, however, it has been suggested that its main mechanism of action resides in the gastrointestinal (GI) tract (5). Using delayed-release metformin that acts predominantly in the gut, Buse et al. (5) found that, despite lower bioavailability, this formulation had greater efficacy than immediate- and extended-release formulations. These findings support the idea that the distal intestine is responsible for most of metformin’s glucose-lowering effect. Proposed mechanisms are an increment in intestinal glucose expenditure and an increase in the secretion of GI incretins (6), as metformin seems to enhance secretion of glucagon-like peptide 1 (GLP-1) and peptide YY. In fact, metformin and dipeptidyl peptidase 4 (DPP-4) inhibitors may increase GLP-1 to a similar extent through different and complementary mechanisms (7).

15. Sodium–Glucose Cotransporter 2 Inhibitor Use Associated With Fournier’s Gangrene: A Review of Case Reports and Spontaneous Post-Marketing CasesСб, 01 янв[−]
Sodium–glucose cotransporter 2 (SGLT2) inhibitors are effective for glycemic control and have demonstrated cardiorenal benefits. The U.S. Food and Drug Administration (FDA) released a boxed warning in 2018 regarding the potential development of Fournier’s gangrene (FG) with the use of SGLT2 inhibitors. FG is a serious perineal infection with a mortality rate of up to 88% in some cases.
To report spontaneous post-marketing cases from the FDA Adverse Event Reporting System (FAERS) database and case reports from the literature of FG associated with the use of SGLT2 inhibitors and to determine whether correlations exist with specific agents.
A search of the FAERS database was conducted to identify reported cases of FG associated with the use of any FDA-approved SGLT2 inhibitor between 1 March 2013 and 30 June 2020. Additionally, a literature search was conducted of PubMed, Embase, and the Cochrane library using PRISMA guidelines to identify case reports of FG with the use of SGLT2 inhibitors up to 9 October 2020.
A total of 491 cases from the FAERS database were included for review. Descriptive analysis depicted more cases in the empagliflozin, canagliflozin, and dapagliflozin groups than in the ertugliflozin group. Nine case reports were included from the literature review; four attributed to dapagliflozin, three to empagliflozin, and two to canagliflozin. The median ages from cases reported in the FAERS database and from the literature review were 54 and 52 years, respectively. In both datasets, males had a higher incidence of FG than females. Additional data reported include clinical outcomes and concomitant antihyperglycemic medications.
Consistent findings are noted in this systematic review and warrant further investigation to elucidate the association between SGLT2 inhibitor use and the development of FG. These results may drive enhanced prescribing patterns to consider patient-specific risk factors and timely monitoring, especially as more indications are approved related to these medications’ cardiorenal protective properties.

16. Combined Dipeptidyl Peptidase 4 Inhibitor and ?-Glucosidase Inhibitor Treatment in Postprandial HypoglycemiaСб, 01 янв[−]
Нет описания

17. Probable Tamsulosin-Induced Hyperglycemia: A Case StudyСб, 01 янв[−]
Нет описания

18. Increasing Diabetes Screening in a Primary Care SettingСб, 01 янв[−]
Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes. The following article describes an initiative to increase rates of diabetes screening in a large multisite academic health system in the greater Ann Arbor, MI, area.

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