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Type 1 diabetes medications

Highlights

Editorial Board member Jay Shubrook follows up with treatment individualization specialist David Strain on the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:08).



Learning points include:

  • The rationale for emphasizing quality over quantity of life in certain subsets of the elderly patient population.
  • The importance of incorporating understanding of key comorbidities into treatment planning, including:
    • Left ventricular and/or diastolic dysfunction
    • Chronic kidney disease 
    • Benign prostatic hyperplasia
    • Heart failure
  • Single/multi-agent therapies capable of targeting hypertension and its comorbidities.
  • The importance of early renal function testing in older adults initiated on treatments for hypertension and its comorbidities.
  • Understanding renal impairment risks in vulnerable adults treated with angiotensin-converting-enzyme (ACE) inhibitors in patients.
  • Understanding the relative risk of hyponatremia with generally well-tolerated treatments like as thiazide diuretics.
  • Best practice for avoiding adverse drug events in the acute setting.
  • The challenges associated with treating concomitant heart failure in older adults.

« Video 4: Individualization of diabetes treatment: Considerations for frail, elderly patients with heart failure

Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton get together once more to discuss best practice tips for identifying and treating hypertension in patients with pre-existing diabetes (12:17).



Learning points include:

  • Strategies to avoid common pitfalls when performing blood pressure measurements.
  • The importance of the blood pressure measurements in determining the risk of cardiovascular events.
  • The benefits of dual-action and preload-targeted therapies in hypertensive patients.
  • Why potassium levels are an important factor to consider before initiating treatment.

« Video 2: Why aren't we reaching blood pressure goals, despite the raised target?



Video 4: Individualization of diabetes treatment: Considerations for frail, elderly patients with heart failure »

In the wake of the revised blood pressure targets, recommended by the American Diabetes Association's 2017 Position Statement and 2018 Standards of Care, Editorial Board member Jay Shubrook and Advisory Board member Robert Chilton discuss clinical approaches to get hypertensive diabetes patients to target more consistently (12:29).


Learning points include:

  • The atherogenic risk posed by diabetes and why blood pressure measurements from the arm-alone may not be sufficient to evaluate the threat in all patients.
  • The benefits and drawbacks of the medication classes indicated for hypertension treatment, such as:
    • Diuretics
    • β-blockers
    • Calcium channel blockers
  • The impact and rationale for targeting blood pressures lower than those indicated in the ADA position statement. 

« Video 2: What are the current recommendations for managing high blood pressure in diabetes patients?



Video 3: When to intervene in patients with diabetes and high blood pressure? »

01-16-2018 | Type 1 diabetes | Editorial | Article

Sodium-glucose cotransporter-2 inhibitors for type 1 diabetes: Ready for prime time?

Editorial board member John Wilding casts a critical eye over the positive buzz surrounding the potential uses of sodium-glucose cotransporter 2 inhibitors in type 1 diabetes treatment.

12-08-2017 | Diagnosis | Case report | Article

A case of maturity onset diabetes of the young (MODY3) in a family with a novel HNF1A gene mutation in five generations

Ovsyannikova AK et al. Diabetes Ther 2018; 9: 413. doi: 10.1007/s13300-017-0350-8

11-08-2017 | Long-acting insulins | Editorial | Article

Longer-acting basal insulin analogs: What, how, why, when, and who?

Advisory Board member and pharmacist, Josh Neumiller, presents a practical guide to support clinical decision-making in the initiation and titration of U300 insulin glargine and insulin degludec.

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