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Volume 33, Number 3 (September/October)

Celiac Disease (pages 10-12)

Marsha Mackenzie, M.S., R.D./L.D.

People with diabetes have a higher incidence of celiac disease, a fact that has contributed to a well-established recommendation that all children with newly diagnosed Type 1 diabetes be screened for celiac disease. This article discusses the diagnosis of and screening for celiac, along with various types of gluten sensitivities and the nutritional options available to people with the disorder.
Complications and comorbiditiesCeliac disease

Emerging Technologies in Rapid-Acting Prandial Insulin (pages 13-18)

David C. Klonoff, M.D., F.A.C.P., Fellow AIMBE

Physicians have long felt “the need for speed” in reference to the insulin therapies they prescribe for their patients with diabetes. The pharmacodynamics and pharmacokinetics of current injected insulin products are still too slow compared with those of naturally released insulin. In this article, several novel ultra-rapid-delivery systems in various stages of development are reviewed.
Drug treatmentInsulin

Insulin Injection Technique for Adults and Children with Diabetes (pages 19-21)

Nadia Shaikh, Pharm.D., Jennifer Goldman-Levine, Pharm.D., C.D.E, B.C.-A.D.M., F.C.C.P

Most of the literature for insulin injection—a task that millions of people with diabetes perform at least once a day—focuses on the safety, efficacy, pharmacodynamics, and pharmacokinetics of insulin itself, rather than on subcutaneous delivery. However, proper injection technique is critical for the optimal control of diabetes. This article reviews such factors for insulin injection as needle size, absorption, site rotation, special considerations, and the role of the health-care professional.
Drug treatmentInsulin

Management of Hypertension in Diabetes (pages 22-23)

Kathleen Wyne, M.D., Ph.D.

In 2013 the American Diabetes Association revised its recommendations to suggest that the systolic blood pressure goal for many people with diabetes and hypertension should be revised to less than 140 mm Hg, with the qualification that lower systolic targets may be appropriate for certain individuals, such as younger patients, if it can be achieved without undue treatment burden. Dr. Wyne examines what prompted this change in the guidelines, and whether clinical practices should change in response.
Professional guidelines