May 1, 2018 Issue
Top 20 Research Studies of 2017 for Primary Care Physicians [Article]

The latest installment of the top 20 research studies for primary care physicians includes studies on cardiovascular disease and hypertension, infections, diabetes mellitus, musculoskeletal problems, and cancer screening, among other topics. The five highest-rated practice guidelines are also summarized.

Apr 1, 2018 Issue
DPP-4 Inhibitors and GLP-1 Receptor Agonists for Prevention or Delay of Type 2 Diabetes Mellitus and Associated Complications [Cochrane for Clinicians]

There is only limited-quality evidence that at-risk patients taking GLP-1 receptor agonists are less likely to progress to diabetes (number needed to treat [NNT] = 23). Serious adverse events were more likely in patients taking GLP-1 receptor agonists than in patients taking placebo (number needed to harm [NNH] = 42).

Feb 15, 2018 Issue
Diabetes Education and Glycemic Control [FPIN's Clinical Inquiries]

Counseling by a diabetes educator or a team of educators delivered in a variety of formats may reduce A1C levels by 0.2% to 0.8% compared with usual care alone. Diabetes educators should be considered for patients who have higher baseline A1C levels (8% to 9%) because this group had greater improvem...

Jan 1, 2018 Issue
Type 2 Diabetes Mellitus: Outpatient Insulin Management [Article]

In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. Insulin regimens should be adjusted every three or four days until self-monitoring of blood glucose targets are reached. Goals should be individualized.

Dec 15, 2017 Issue
Home Glucose Monitoring Offers No Benefit to Patients Not Using Insulin [POEMs]

Home glucose monitoring of patients in primary care does not improve A1C scores or quality of life over one year in patients who are not taking insulin.

Dec 1, 2017 Issue
Hyperosmolar Hyperglycemic State [Article]

Although this life-threatening emergency commonly affects adults with type 2 diabetes mellitus, its incidence is increasing in children. Read the latest evidence on causes, risk factors, and complications, and get a treatment algorithm from the American Diabetes Association.

Nov 15, 2017 Issue
Glucose Management in Hospitalized Patients [Article]

Challenges to glucose control in hospitalized patients with type 2 diabetes mellitus include determining blood glucose targets, judicious use of oral diabetes medications, and implementing appropriate insulin regimens. Home oral diabetes medications should be continued in the absence of contraindications. Insulin dosing is based on patient factors, such as current oral intake, comorbidities, baseline diabetic control, and experience with prior insulin therapy. Sliding scale insulin regimens are not recommended.

Oct 15, 2017 Issue
Newer Oral Hypoglycemics Do Not Increase or Decrease Mortality [POEMs]

This seems like a strange question considering that the goal is to decrease mortality with drug therapy. Nevertheless, this study showed that the new kids on the diabetes block—exenatide (Byetta), dulaglutide (Trulicity), sitagliptin (Januvia), saxagliptin (Onglyza), and others—do not increase mortality, even in patients with cardiovascular risk.

Oct 15, 2017 Issue
Dulaglutide (Trulicity) for Type 2 Diabetes Mellitus [STEPS]

Dulaglutide is an easy-to-use, once-weekly injectable therapy for the treatment of type 2 diabetes in adults. It produces a modest decrease in A1C levels with only a small risk of severe hypoglycemia. The small average weight loss it induces may be an advantage for some patients.

Oct 1, 2017 Issue
Type 2 Diabetes Mellitus: ACP Releases Updated Recommendations for Oral Pharmacologic Treatment [Practice Guidelines]

The American College of Physicians (ACP) previously released guidelines in 2012 regarding the effectiveness and safety of oral pharmacologic treatment for type 2 diabetes; however, new evidence has emerged and new drugs have been approved by the U.S. Food and Drug Administration. For this reason, th...

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