Mary & Dick Allen Diabetes Center. Hoag Annual Diabetes Conference: Diabetes: What s New? What s Next? November 13, 2015

Transcription

1 Mary & Dick Allen Diabetes Center Hoag Annual Diabetes Conference: Diabetes: What s New? What s Next? November 13, 2015

2 Pumps and Sensors Of Machines & Men by Mark Daniels, MD Updates on types of blood glucose monitors and devices. ConnecKvity and CommunicaKon: Pa$ents with diabetes can monitor their blood glucose and stay connected with their providers, family, and school/work. Tracking PaMerns: Devices with sensors can help pa$ents manage their peaks and lows, including nutri$onal (meal$me planning) or medica$on adjustment. Pros: BeCer control of glucose levels, pa$ent accountability and more ownership of care. Cons: Poten$al informa$on overload when viewing test results on cloud/monitoring pa$ents, some sensors hurt pa$ents.

3 ProtecKng the Brain from Damage in those with Diabetes by William R. Shankle, MS, MD, FACP CogniAve impairment in paaents with diabetes and protecang the brain from damage in those with diabetes. Physiological Effects: Differences between normal aging, mild cogni$ve impairment, and demen$a. 4 main causes of cogni$ve impairment are Alzheimer s Disease, Vascular disease, metabolic syndrome, and depression. Early DetecKon and Treatment: Progression of cogni$ve impairment can be delayed by 5-10 years if detected and treated early with cholinesterase inhibitor + Namenda. Healthcare providers must monitor cogni$ve func$on annually for pa$ents who have diabetes or pre- diabetes.

4 Filling An Unmet Need in Lipid Treatment: PCSK9 Inhibitors by DipK Itchhaporia, MD, FACC The importance of the PCSK9 Inhibitor and its effects on LDL levels. Role of PCSK9 on LDL levels: When PCSK9 binds to the LDL receptor, the LDL receptor is broken down and can no longer remove LDL cholesterol from the blood. If PCSK9 is blocked, more LDL receptors will be present on the surface of the liver and will remove more LDL cholesterol from the blood. Therefore, blocking PCSK9 can lower blood cholesterol levels Research: Sta$n treatment alone decreased LDL levels by 20-25%, but in combina$on with a PCSK9, the reduc$on was between 50-70%. Treatment: FDA recently approved treatment using PCSK9 inhibitors; however, treatment cost is too high (approx. $14,0000 per year).

5 Yoga for Diabetes and Pregnancy by Milka Gronlund, PhD, PsyD, MBA The benefits of yoga for those who have diabetes and/or are pregnant. Overall Benefits: Yoga helps to massage internal organs ul$mately improving blood flow, can help prevent injuries, and helps with psychosocial components of dealing with the disease. Yoga and Diabetes: The key to using yoga as an addi$ve therapy for pa$ents with DM is to modify movements to the personal capability of the pa$ent and to prevent fall risk and overexer$on while having the right equipment. Yoga can be recommended to all pa$ents, especially for diabetes and pregnant women because it can help pa$ents to relax, calm, sleep and rest becer.

6 Diet and Exercise Guidelines for GestaKon Diabetes by Meghan Gonzalez, RD, CDE Diet & exercise guidelines for pregnant women with GDM Diet Guidelines: GDM meal plan should be followed and weight must be monitored closely. Fruits should be limited to lunch, dinner, or AM/PM snacks and avoided at breakfast and bed$me. Some types of fish (canned light tuna, salmon, pollock, and cafish) are safe to eat. To minimize chances of listeriosis, one must avoid sog cheeses that are not made with pasteurized milk and make sure meats are thoroughly cooked. Limit caffeine at 200 mg/day is rendered safe during pregnancy. Exercise Guideline: The recommended amount of exercise is 30 minutes a day or on most days if physical condi$on allows and with health provider s clearance.

7 Young Adults with Diabetes TransiKon of Care by Anne Peters, MD The transiaon of care for young adults with type 1 diabetes from pediatrics to adulthood care. DefiniKon of transikon of care: The transi$on from pediatric to adulthood occurs from years old, during which the brain is maturing in regards to its decision making ability. Common problems in transikon care: Poor communica$on between providers and pa$ents, lack of quality improvement, and coverage gaps/fall out periods. The worst outcomes during the transi$on period for young adults have been seen in children that come from broken homes.

8 Synergizing InnovaKons in NutriKon & Medical Management of Type 2 Diabetes by Daniel A. Nadeau, MD Managing diabetes through proper medicaaon and good nutriaon. Chrosmosomal Effects: Telomeres are a marker for aging. A plant based diet can lead to a 10% increase in telomere length. Cellular Effects: A major benefit of GLP- 1 agonists is that it s$mulates glucose- dependent insulin secre$on minimizing hypoglycemia and a safer choice to sulfonylureas. Use of SLGT 2 inhibitors can poten$ally decrease doses of sulfonylureas, diure$cs and insulin.

9 Mary and Dick Allen Diabetes Center Hoag Annual Diabetes Conference: Diabetes: What s New? What s Next?! Dr. Mark Daniels shared updates on types of blood glucose monitors and devices.! Dr. Shankle discussed cogni$ve impairment in pa$ents with diabetes and protec$ng the brain from damage in those with diabetes.! Dr. Itchhiporia focused on the importance of the PCSK9 Inhibitor and its effects on LDL levels.! Dr. Gronlund shared the benefits of yoga for those who have diabetes and/or are pregnant.! Ms. Gonzalez shared updates on the most recent diet and exercise guidelines for pregnant women with gesta$onal diabetes.! Dr. Peters provided insight regarding the transi$on of care for young adults with type 1 diabetes from pediatrics to adulthood care.! Dr. Nadeau concluded the conference with an emphasis on the importance of managing diabetes through proper medica$on and good nutri$on.