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Diabetes Crossfire

In this series of mini-debates, a panel of distinguished faculty tackles five of the most pressing questions in diabetes today. How would you treat these patients?

Moderated By:
Zachary T. Bloomgarden, MD, FACE
Clinical Professor, Department of Medicine, Mount Sinai School of Medicine
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Diabetes Crossfire
Paul S. Jellinger, MD, MACE
Professor of Clinical Medicine, University of Miami, Past President, American College of Endocrinology (ACE), Past President, American Association of Clinical Endocrinologists (AACE)
Vivian Fonseca, MD
Professor of Medicine and Pharmacology, Tullis Tulane Alumni Chair in Diabetes, Chief, Section of Endocrinology, Tulane University Health Sciences Center
Zachary T. Bloomgarden, MD, FACE
Editor, the Journal of Diabetes, Clinical Professor, Department of Medicine, Mount Sinai School of Medicine
(1,275)
356 Comments
Vivian Fonseca MD
Professor of Medicine and Pharmacology, Tullis Tulane Alumni Chair in Diabetes, Chief, Section of Endocrinology, Tulane University Health Sciences Center
Jaime A. Davidson, MD, FACP, MACE
Clinical Professor of Medicine, Touchstone Diabetes Research Center, Division of Endocrinology, Diabetes and Metabolism, University of Texas, Southwestern Medical Center
Zachary T. Bloomgarden, MD, FACE
Editor, the Journal of Diabetes, Clinical Professor, Department of Medicine, Mount Sinai School of Medicine
(1,284)
244 Comments
Jaime A. Davidson, MD, FACP, MACE
Clinical Professor of Medicine, Touchstone Diabetes Research Center, Division of Endocrinology, Diabetes and Metabolism, University of Texas, Southwestern Medical Center
Faramarz Ismail-Beigi, MD, PhD
Interim Division Chief, Endocrinology, University Hospitals, CMC, Professor, Department of Molecular Endocrinology, Case Western Reserve University, School of Medicine
Zachary T. Bloomgarden, MD, FACE
Editor, the Journal of Diabetes, Clinical Professor, Department of Medicine, Mount Sinai School of Medicine
(927)
367 Comments
Latest Comments
"This was an excellent, well-organized succinct presentation regarding the use of glycemic targets in treatment of diabetes.  Your lecture was greatly enhanced by the group presentation.  As well as, the panel's experience and expertise as physicians and professors in endocrinology.  Individualization of pt care relating to multiple factors need to be taken into consideration, i.e. the pt’s level of activity, diet, compliance with TX and their daily activity related to the pt’s routine all must be all be weighed. 

Initiating the beginning morning dosage of basal and then titrating Q 3 Days for ~ 1-2 mo which permits the pt time to gain an increased assurance and awareness concerning diabetes and risks of non-compliance.  The influence of adhering to the lifestyle changes recommended i.e. activity level/diet ordered  can aid in successfully meeting the challenges with this disease.  If the pt’s HGB A1C does not < significantly, then you can add a meal time bolus – as well as the old concept of sliding scale to cover pre-meal glucose level. 

Your pt may have a hectic schedule just like ours, but they must take time out to learn to adapt in order to be successful with their disease.  They must incorporate proper changes within their lifestyle and work together with their PCPs in order to be successful. 

Compliance is much better if the individual works toward incrementalization of their changes with truly understanding their disease – working one step at a time.  Thus, this will type of change permits the pt to be not only better educated, but increased knowledge can help the pt become a better supervisor of their disease.

Again, thank you for revitalizing my knowledge related to diabetes.  It is always enlightening to reflect on the various pathways in treatment diabetes.

Thank You!

Valerie"
Valerie Ting, APRN-BC
Nurse Practitioner, Comprehensive Health Center
367 Comments
"This was an excellent, well-organized succinct presentation regarding insulin therapy and wether to start basal alone or use a basal/bolus method.  Your lecture was greatly enhanced by the group presentation.  As well as, the panel's experience and expertise as physicians and professors in endocrinology.

It is also important that we as health care professionals keep up-to-date on our continuing education in order to be prepared to treat our pts to the best of our ability. 

Diabetes is one area where we need to keep current in order to prevent disease progression and other comorbidies.  We all need to have access to current  up-to-date information concerning Diabetes and other diseases. 

Thankfully, today with the Internet and the wealth of other medical web-sites, obtaining current information simply @ our fingertips.  Yes, indeed, we are blessed to have  QuantiMD and other medical websites to keep current and have CME accessible to assist us with this task.         

 

Thanks,

 

Valerie"
Valerie Ting, APRN-BC
Nurse Practitioner, Comprehensive Health Center
244 Comments
 
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