Current Issue


Program directs stable diabetes patients from endocrinology back to primary care

One academic health system developed a program to “graduate” patients out of endocrinology visits for their diabetes. Criteria included HbA1c level less than 8.0%, blood pressure less than 140/90 mm Hg, no tobacco use, and use of statins and aspirin if needed.

Initiation of glucose-lowering therapies may be associated with reduced physical activity

An analysis of 148 participants from three randomized trials found that starting liraglutide, empagliflozin, or sitagliptin was associated with reduction in physical activity of about 1,000 steps per day or 10 minutes of moderate to vigorous physical activity per day.

Patients diagnosed by OGTT without elevated HbA1c had similar CV, renal disease risks as those without diabetes

A prospective U.K. study found that patients with diabetes based on an oral glucose tolerance test (OGTT) often did not have a diabetic HbA1c level, and risks of cardiovascular (CV) and kidney disease in these patients were similar to those in the nondiabetic general population.

MKSAP quiz: Medication management

This month's quiz asks readers to choose the next step in treatment for a 62-year-old woman with type 2 diabetes, hypertension, and an estimated glomerular filtration rate of 50 mL/min/1.73 m2.

Spotlight on innovative uses of CGM

Recent trials indicated effectiveness of open-source automated insulin delivery systems, inpatient insulin management based on continuous glucose monitoring (CGM), and CGM for certain patients with type 2 diabetes who are not taking insulin.

In type 2 diabetes, SGLT2 inhibitors reduced risk for serious hyperkalemia without increasing hypokalemia

A reduction in hyperkalemia could allow use of angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, or aldosterone-receptor blockers in at-risk patients, justifying the prescribing of sodium-glucose cotransporter 2 (SGLT2) inhibitors, an ACP Journal Club commentary said.

Treatment pathways compared for diabetic peripheral neuropathy

Amitriptyline supplemented with pregabalin, pregabalin supplemented with amitriptyline, and duloxetine supplemented with pregabalin were similarly effective for controlling pain, a recent study found.