Diseases Commons^™

A Call To Action On Prediabetes, Joy A. Moverley, Alegria Cantillep, Kathryn Newberry, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Diabetes and prediabetes have become an epidemic in the United States. The keys to battling this public health challenge are effective screening and evidence-based interventions. Studies show that intensive lifestyle interventions, medications, and weight loss surgery can reduce or delay new-onset type 2 diabetes. This article reviews the steps clinicians can take to help patients stay ahead of this disease.

Rationale For, Initiation And Titration Of The Basal Insulin/Glp-1ra Fixed-Ratio Combination Products, Ideglira And Iglarlixi, For The Management Of Type 2 Diabetes, Virginia Valentine, Jennifer Goldman, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Type 2 diabetes (T2D) is a progressive disease affecting glucose regulation and a major cause of morbidity and mortality globally. Many patients are not escalated up the treatment ladder appropriately despite failing to achieve glycemic control, with barriers such as fear of hypoglycemia, weight gain, and treatment burden recognized as factors. Exogenous basal insulin is titrated to address control of fasting plasma glucose and may preserve residual β-cell function, thus promoting a greater endogenous prandial insulin response. Native glucagon-like peptide-1 (GLP-1) is a peptide hormone secreted by the gut in response to nutrient ingestion; it increases insulin secretion, inhibits glucagon …

Cardiometabolic Risk Factors, Metabolic Syndrome And Pre-Diabetes In Adolescents In The Sierra Region Of Ecuador, Sharon L. Casapulla, Cheryl A. Howe, Gabriela Rosero Mora, Darlene Berryman, Mario J. Grijalva, Edgar W. Rojas, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Background: Excess weight (overweight and obesity) is the major modifiable risk factor for type 2 diabetes mellitus (T2DM) and other non-communicable diseases. However, excess weight may not be as predictive of diabetes risk as once thought. While excess weight and other obesity-related non-communicable diseases are of growing concern in low-middle income countries in Latin America, there is limited research on risk factors associated with T2DM in adolescents. This study investigated prevalence of overweight, obesity, prediabetes, diabetes and metabolic syndrome in adolescents in Ecuador.

Methods: A cross-sectional study was conducted with 433 adolescents from two schools in a small …

Diabetes Update: Your Guide To The Latest Ada Standards, Eric Johnson, Florence Warren, Neil Skolnik, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

The authors highlight the latest changes in the ADA standards and review recommendations of particular relevance for family physicians.

Insulin Pumps: Beyond Basal-Bolus, Richard Millstein, Nancy Mora Becerra, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Insulin pumps are a major advance in diabetes management, making insulin dosing easier and more accurate and providing great flexibility, safety, and efficacy for people who need basal-bolus insulin therapy. They are the preferred treatment for people with type 1 diabetes and many with type 2 diabetes who require insulin. This article reviews the basics of how insulin pumps work, who benefits from a pump, and how to manage inpatients and outpatients on insulin pumps.

Program Active Ii: Design And Methods For A Multi-Center Community-Based Depression Treatment For Rural And Urban Adults With Type 2 Diabetes, Mary De Groot, Jay H. Shubrook, Frank Schwartz, W. Guyton Hornsby Jr., Yegan Pillay, Chandan Saha

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Objective: Depression affects one in four adults with type 2 diabetes (T2DM) and is associated with worsened diabetes complications, increased health care costs and early mortality. Rural and low-income urban areas, including the Appalachian region, represent an epicenter of the T2DM epidemic. Program ACTIVE II is a comparative effectiveness treatment trial designed to test whether a combination of cognitive behavioral therapy (CBT) and community-based exercise (EXER) will offer greater improvements in diabetes and depression outcomes compared to individual treatment approaches and usual care (UC). The secondary aims are to assess changes in cardiovascular risk factors across groups and to …

Empagliflozin In The Treatment Of Type 2 Diabetes: Evidence To Date, Jay H. Shubrook, Babak Baradar Bokaie, Sarah E. Adkins

Faculty Publications & Research of the TUC College of Osteopathic Medicine

In the last decade, researchers have gained a greater understanding of the pathophysiologic mechanisms of type 2 diabetes as a chronic and progressive disease. One of the more recent treatment targets is the kidney. The kidneys become maladaptive in diabetes by increasing the reabsorption of glucose above the normal physiologic renal threshold. This discovery has led to the development of the sodium/glucose cotransporter 2 inhibitors (SGLT2). These agents readjust the renal threshold for glucose reabsorption to a lower level and decrease glucose reabsorption, while increasing urinary glucose when the glucose is above the renal threshold and subsequently lowering plasma glucose. …

Sodium Glucose Co-Transporter 2 Inhibitors In The Treatment Of Type 2 Diabetes Mellitus, Eden Miller, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Type 2 diabetes mellitus (T2DM) is a chronic, progressive disease, control of which typically requires multiple therapies. Current guidelines suggest that, in addition to improving glycemic control, antihyperglycemic therapy should be chosen on the basis of its effects on body weight and the risk of hypoglycemia. The newest class of oral antihyperglycemic agents, the sodium glucose cotransporter 2 (SGLT2) inhibitors, reduces renal glucose reabsorption and increases urinary glucose excretion via an insulin-independent mechanism of action. SGLT2 inhibitors have been shown to improve glycemic control and to reduce body weight and systolic blood pressure, and their use is associated with a …

What To Do After Basal Insulin: 3 Tx Strategies For Type 2 Diabetes, Lubaina Presswala, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

While many family physicians have become comfortable with using once-daily basal insulin such as glargine or detemir, what to do after basal insulin is much more complex. This review builds upon an earlier article in this journal, “Insulin for type 2 diabetes: How and when to get started,” by explaining 3 strategies to consider when basal insulin alone isn't enough.