Research Highlights from Diabetes Conference
Jul 17, 2013, 00:00 AM
This past weekend I attended the 9th Annual Diabetes Conference sponsored by Texas A&M Health Science Center’s Coastal Bend Health Education Center in Corpus Christi, Texas. They had an excellent program with top notch speakers. I learned so much, and I want to share a few highlights with you.
Jorge Mestman, MD, USC, Los Angeles CA
Update on Gestational Diabetes
Five years post-pregnancy, 50 percent of women with gestational diabetes develop diabetes. At the first prenatal visit, check for overt diabetes as many women have undiagnosed type 2 diabetes at conception. No studies have shown that any one diet is better than another. In addition, there are no good studies on activity during pregnancy. But, he feels the best time for moms to walk is after breakfast since that is the time when insulin resistance is the highest and there is more hyperglycemia.
Philip Raskin, MD, FACP, FACE, CDE, UT Southwestern Medical Center, Dallas, TX
Outpatient Use of Insulin in Type 2 Diabetes
The take home message here was to be reasonable and individualize treatment. It’s important to assess each patient and set appropriate goals. Glucose goals of 7 percent may not be right for all patients. Setting glucose goals that are lower can be for elderly patients or those with cardiovascular disease. Based on the Metabolic Memory of the DCCT and the Legacy Effect from UKPDS, the effects of early treatment last longer than delayed treatment. Furthermore, 50 percent of beta cells are “gone” by the time of diagnosis.
Veronica Piziak, MD, PhD, Scott and White Healthcare, Temple TX
New Clinical Guidelines
New risk factors for diabetes have been added. They include: anti-psychotic drugs, cardiovascular disease and insulin resistant states such as polycystic ovary syndrome, hypertriglyceridemia and low HDL. The best way to treat triglycerides is lifestyle, lifestyle, lifestyle. When teaching SMBG, it is imperative that patients know what to do with the numbers. There are new guidelines for testing frequency and diabetic shoe guidelines.
Kathleen Wyne, MD, PhD, FACE, FNLA, Methodist Hospital Research Institute, Houston, TX
New Options in the Medical Management of Obesity
AMA has finally recognized obesity as a disease. Now, insurance will have to reimburse for drugs for treatment as well as surgery. To lose weight, you must reduce calories. To maintain weight loss, you must increase activity. The biggest problem is weight regain. It is important to have a structured program to maintain weight loss. Many patients are utilizing weight loss surgery, but there are concerns about the often irreversible changes in body anatomy. Two new meds are now available – Qsymia and Belviq.
Larry Lipshultz, MD, Baylor College of Medicine, Houston, TX
Testosterone Deficiency
Causes of hypotesterone:
|
Opiate Use
|
74 %
|
Obesity
|
50%
|
|
Diabetes
|
50%
|
AIDS
|
50%
|
|
HTN
|
40%
|
Elevated Lipids
|
40%
|
Men with low testerone have earlier mortality.
Ralph DeFronzo, MD, University of TX Health Science Center, San Antonio, TX
Insulin Resistance
Microvascular disease decreases quality of life. Macrovascular disease increases mortality. Recent studies have shown glycemic control has no real impact on macrovascular disease. Hyperglycemia is not a risk factor for atherosclerotic cardiovascular disease. What we need is one drug that is completely safe and promotes weight loss. There is not yet any drug in that category.
These are just a few of the highlights from the conference. If you need your batteries recharged with new information, don’t forget that AADE13 is coming up soon. There is still time to register!