Home > Archive > 2017 >

Volume 36, Number 3 (September/October)

Should SGLT2 Inhibitors Be Used to Treat Type 1 Diabetes? (pages 2-6)

Kathleen Wyne, MD, PhD, Associate Professor, Division of Endocrinology, Diabetes and Metabolism The Ohio State University, Wexner Medical Center Columbus, Ohio

This question has garnered a great deal of interest since the first agents in the class received FDA approval for treating Type 2 diabetes. Clinical trial data involving people with Type 1 diabetes have shown some promising results. However, clinically significant safety concerns have limited the interest in further investigation of these agents for Type 1 diabetes.
Drug treatmentSodium-glucose cotransporter 2 inhibitors

The Cadillac Combination for Type 2 Diabetes: A GLP-1 receptor Agonist and a SGLT2 Inhibitor (pages 10-13)

David S. H. Bell, MB, FACE, FACP Professor of Medicine (retired) University of Alabama and Southside Endocrinology Birmingham, Alabama, and Edison Goncalves, MD, FACE, FACP Diabetes and Thyroid Associates Birmingham, Alabama

In choosing drugs to treat Type 2 diabetes, insulin, sulfonylureas and other secretagogues are not a prudent initial choice due to the increased risk of hypoglycemia associated with their use. Similarly, drugs that lead to weight gain (insulin, secretagogues, thiazolidinediones) should be avoided due to the potential of increasing insulin resistance.
Drug treatmentSodium-glucose cotransporter 2 inhibitors

Commentary: Application of the AACE 2017 Lipid Guidelines to Diabetes (pages 7-9)

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

The updated American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) Guidelines for Management of Dyslipidemia and Prevention of Cardiovascular Disease were published in early 2017. Changes in this clinical practice guideline included the introduction of a new category of “extreme risk” with a low-density lipoprotein cholesterol (LDL-C) target of <55 mg/dl and an expanded discussion of lipid management in people with diabetes.
Complications and comorbiditiesCardiovascular diseaseDyslipidemia

Engaging the Family in Diabetes Management: Educator’s Corner (pages 14-17)

Annie Chathanatt Mathew, PharmD, CDE, Ambulatory Care Specialist, Parkland Health and Hospital System, Dallas, Texas

Rosalyn, a 74-year-old female, has uncontrolled Type 2 diabetes and multiple comorbidities. She has arrived for her initial diabetes visit, accompanied by her adult daughter. When her name is called, Rosalyn proceeds forward alone while her daughter remains in the waiting area. The educator asks Rosalyn if she would like to have her daughter join her for the visit. Rosalyn is open to the suggestion, and her daughter is invited to attend the visit. The educator explains the reason for the visit and the benefits of the daughter’s participation. The opportunity to foster family support is quite often overlooked. Implementing family support as part of your patient’s care may be as simple as inviting a relative to join the visit.
Educator's Corner