Perspectives on Diabetes Care
This is the official blog of the Association of Diabetes Care & Education Specialists where we share recent research and professional opinions on diabetes care and education.
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Exciting Times on the Diabetes Front
Jul 28, 2016, 16:05 PM
M
edscape described the 76th Scientific Sessions of the American Diabetes Association as showcasing “practice changing clinical trial data.” It was an incredible four days of scientific sessions, abstracts, poster sessions and exhibits held in New Orleans. I feel very fortunate I was able to attend.
These are very exciting times for diabetes because new medications and treatments are being developed at an incredible rate. I am going to try to summarize the highlights for you.
- Foot ulcers have reached world epidemic proportions. It was stated that one-third of the cost of all foot ulcers are related to diabetes. Diabetic foot ulcers cost more than all cancer costs combined. 85 percent of diabetic foot ulcers are preventable. This presentation focused on properly fitting shoes, observation and prevention of pressure spots, the use of a mirror to observe the bottoms of their feet and regular checkups by Primary Care Providers. It was stressed that walking was important to maintain proper circulation, enhance blood flow to lower extremities and improve joint flexibility.
- “Repurposing Metformin” reminded us that Metformin is not metabolized by any organ but is excreted, unchanged, via the kidneys. Based on over 20 years of experience, the FDA continues to liberalize and revise their recommendations for use. The relationship between Metformin and Cancer continues to be closely studied.
- The Precision Medicine Initiative focuses on the right medicine to the right patient at the right time (sounds very familiar to what we as nurses have practiced for years). Current medications are considered “cookie cutter” with all patients being treated the same. This Initiative promotes a more accurate diagnosis and specific drugs for each patient based on their particular disease process and expected outcome.
- The Empa-Reg study was significant with its report of cardiovascular protection provided by empagliflozin. The researchers stated they were surprised by the early impact on decreasing workload on the heart and how “failing” hearts could be saved with this drug.
- “Good Fat – Bad Fat” was interesting. Good fat is described as the fat you can see and feel. Bad Fat is the kind that is stored deep within the body and requires an MRI to see and measure it. More studies to follow.
- Bone Biology in Diabetes was well attended. It was reported that there is an increased risk of bone and skeletal issues in diabetes. Type 1 diabetes is associated with three to four times increased risk of fractures. With several diabetes drugs now being examined for their relationship to increased fractures, more studies are needed to clarify the cause of the skeletal issues.
- A session on Quality of Life was a good reminder that we continue to deal with real people with real lives. We need to listen to them and work with them to provide the appropriate quality care.
I sat in on a few Molecular Metabolism and Epidemiology sessions just to see what was new outside my scope of practice. WOW! There are some very intelligent, thoughtful people who understand all that data. I will not even try to explain what they were presenting.
Overall, it was a very good meeting with a lot of new and exciting information. I am looking forward to AADE16 and the new information my colleagues have to share. I hope to see you in San Diego!
About the Author
Barbara Walz is an RN, BSN and has been a certified diabetes educator since 1986. Since 2000, Barbara has coordinated a multi-site diabetes study examining the macro-vascular effects of diabetes at the South Texas Veterans’ Healthcare System under the supervision of Dr. Ralph DeFronzo.