In the past decade or so, our attempts to define the "earliest” events in Type 2 diabetes (T2DM) have moved increasingly earlier. We’re considering even the years before what we now consider to be the “pre-diabetes” stage—that is, years considerably before there are any clinical signs or symptoms of disease.
Primary care physicians are expected to be experts on dozens of different disease states despite the fact that each medical problem continues to evolve, with new understanding of the disease itself and its treatments.
Alternative medicine (also known as complementary medicine) has become a multibillion dollar industry. A subset of complementary medicine is dietary supplements–many of which may hold promise as adjuncts to more traditional therapies and treatments. The evidence basis for many of these ”therapies,” however, often remains immature and at best anecdotal in nature.
For many years now, the concept of an artificial pancreas – a machine that could replace the functions of the pancreas lost due to diabetes – has been appealing and sought after.
A hot topic in the type 2 diabetes world is whether we have in hand the tools to stop the decline in beta cell function that typifies this disease and, consequently, a therapy or therapies that successfully control blood glucose for many years – so-called treatment durability.
In considering the subject matter for my next blog, my mind wandered a bit and settled on a patient with type 2 diabetes I had seen last week. While riding her bicycle, she had suddenly felt dizzy and disoriented and side swiped a parked car.
While traveling to the American College of Physicians meeting last week in San Diego, I read an interesting article sent to me from the Corpus Christi Caller-Times by Dr. Stephen Ponder.
Our patient represents a common scenario in primary care–failure to get to goal A1C despite taking two oral diabetic medications. The most critical point I can make is to do something! Diabetes is a progressive disease, and without a significant weight loss our patient’s
As I think about the many new advances in our understanding and treatment of Type 2 diabetes mellitus (T2DM), three points come to mind that have implications for future treatment of diabetes in primary care:
This was supposed to be an important week for the diabetes world, with approval of the first long-acting incretin therapy (exenatide LAR, Bydureon®). In a bit of a stunner, on October 19th the FDA issued a complete response letter to the manufacturers of the once weekly exenatide requesting additional studies before considering approval.
