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Volume 28, Number 2 (May/June)

Use of Bile Acid Sequestrants to Treat Type 2 Diabetes (pages 6-15)

Charles A. Reasner, M.D.

Atherogenic dyslipidemia—the combination of low HDL-cholesterol levels, high triglyceride levels, and a preponderance of small, dense LDL particles—is often seen in patients with Type 2 diabetes. In this wide-ranging and thorough article, Dr. Reasner examines the connection between Type 2 diabetes and atherogenic dyslipidemia, emphasizing that complete Type 2 diabetes treatment must address both glycemic control and the conditionÓ³ micro- and macrovascular complications. To this end, the article reviews evidence for lowering LDL cholesterol with bile acid sequestrants and statins, for raising HDL cholesterol with fibrates and niacin, and for improving the lipid profile with tight glycemic control. It then turns its focus to the LDL- and blood glucose-lowering effects of bile acid sequestrants, explaining how these medications work and suggesting an important role for them in diabetes treatment.
Drug treatmentCholesterol-lowering drugs
Complications and comorbiditiesCardiovascular diseaseDyslipidemia

The Importance of Exercise in Patients with Diabetes (pages 16-24)

Puntip Tantiwong, M.D., and Nicolas Musi, M.D.

Exercise is a well-documented modality for preventing and treating Type 2 diabetes and has been shown to have a modest effect on glycemia. In clear detail, Drs. Tantiwong and Musi examine the mechanisms by which exercise has this effect, making a strong argument for the key role of exercise in effective diabetes treatment. The article reviews how exercise stimulates glucose transport in the muscle through insulin-independent pathways, increases insulin sensitivity in the muscle, and induces adaptations in the muscle. The second part of the article offers practical recommendations for prescribing exercise to diabetic patients and includes advice on exercise in patients with PAD, retinopathy, neuropathy, and nephropathy.
Management strategies and toolsPhysical activity

Should We Use Statins to Lower C-reactive Protein?—Lessons From JUPITER and AURORA (pages 24-25)

Charles A. Reasner, M.D.

The recent JUPITER and AURORA trials investigated the effect of rosuvastatin on LDL-cholesterol levels, C-reactive protein levels, and heart disease risk. The Editor reviews the results of both studies and discusses reasons for why they arrived at such different conclusions.
Complications and comorbiditiesCardiovascular disease
Drug treatmentCholesterol-lowering drugs

Diabetes in the Bedroom (pages 26-31)

Janis Roszler, R.D., C.D.E., L.D.N.

Sexual complications are an unfortunate fact of life for many people with diabetes. This article clearly examines the various causes of these complications and their treatments in both men and women. Also included is advice on helping your patients open up about this sometimes-uncomfortable topic.
Complications and comorbiditiesSexual complications
Management strategies and toolsSexual health