Katia Cristina Portero McLellan, Ph.D., Nutrition, and Lance A. Sloan, M.D., M.Sc., F.A.C.E. Texas Institute for Kidney and Endocrine Disorders, Lufkin, Texas
Many anthropometric measures such as body-mass index, waist circumference, waist-to-height ratio and waist-to-hip ratio are used in epidemiological studies to define overweight and obesity, estimate body fat distribution and identify people at elevated obesity-related health risk. This paper aims to describe the usefulness of anthropometric indicators to predict cardiometabolic risk in clinical practice.
Complications and comorbidities — Cardiovascular disease
David S. H. Bell, M.D., Professor Emeritus, Department of Medicine, University of Alabama Birmingham
The ADA/EASD guidelines list sulfonylureas at the top of the list of drugs to be added in the Type 2 diabetes patient when metformin fails. While these guidelines state that the drugs on this list are not prioritized, the drugs are not listed in alphabetical order. The AACE guidelines specifically recommend the addition of an incretin mimetic or, if injection therapy is not desired, a SGLT2 receptor blocker as the next choice when metformin monotherapy is not adequate. Based on personal experience with prior authorizations, it is very obvious the third-party payers prefer the ADA/EASD criteria because of the minimal cost of both sulfonylureas and metformin. The AACE guidelines recommend caution in using sulfonylureas, thiazolidinedione and insulin due to their potential adverse effects.
Drug treatment — Sulfonylureas
This column highlights recent clinical trial data and
landmark clinical trials to provide readers with relevant
information and links for obtaining trial data and
articles to facilitate discussions with patients and other
providers. It features the results of three trials:
Liraglutide Effect and Action in Diabetes: Evaluation
of Cardiovascular Outcome Results – A Long Term
American Diabetes Association,
New Orleans, June 2016:
Session LB-01 – Late Breaking Poster Session
99-LB / 99 – Pivotal Trial of a Hybrid Closed-Loop
System in Type 1 Diabetes (T1D)
Session 1-AC-OR06 – Hypoglycemia Potpourri
349-OR / 349 – Risk Assessment of Using the New
Continuous Glucose Monitoring (CGM) System for
Treatment Decisions (Patients 2 YO+)
Kathleen Wyne, M.D., Ph.D.
How many times have patients asked you why they cannot continue using their old meter now that they have Medicare coverage? Or asked for prescriptions for a new meter and supplies because Medicare won’t cover their old meter? The easy way to deal with this is just to agree to prescribe the one the patient’s pharmacy or mail-order company is requesting. But is that the right thing to do when we know it may compromise the patient’s safety if the new meter is unreliable and could lead to insulin dosing that may be too high or too low?
Health services and insurance