Serving To Educate Primary Care Clinicians On Metabolic Issues
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Consultant 360 Metabolic Disease Articles July 2017
July 2017 Metabolic Disease Articles from our Partners at Consultant 360
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Consultant 360 Metabolic Disease Articles June 2017
June 2017 Metabolic Disease Articles from our Partners at Consultant 360
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Consultant 360 Metabolic Disease Articles May 2017
May 2017 Metabolic Disease Articles from our Partners at Consultant 360
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Consultant 360 Metabolic Disease Articles April 2017
April 2017 Metabolic Disease Articles from our Partners at Consultant 360
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Consultant 360 Metabolic Disease Articles March 2017
March 2017 Metabolic Disease Articles from our Partners at Consultant 360
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Consultant 360 Metabolic Disease Articles February 2017
February 2017 Metabolic Disease Articles from our Partners at Consultant 360
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Free CE on ADA's 2017 Standards of Care
The American Diabetes Association’s 2017 Standards of Medical Care in Diabetes webcast is tailored just for you.
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Consultant 360 Metabolic Disease Articles January 2017
January 2017 Metabolic Disease Articles from our Partners at Consultant 360
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Consultant 360 Metabolic Disease Articles December 2016
December 2016 Metabolic Disease Articles from our Partners at Consultant 360
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Consultant 360 Metabolic Disease Articles November 2016
Metabolic Disease Articles from our Partners at Consultant 360
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Consultant 360 Metabolic Disease Articles October 2016
Metabolic Disease Articles from our Partners at Consultant 360
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Consultant 360 Metabolic Disease Articles September 2016
Consultant 360 Metabolic Disease Articles September 2016
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Consultant 360 Metabolic Disease Articles August 2016
Metabolic Disease Articles from our Partners at Consultant 360
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Prescriber's Letter August 2016
Vaccines: You'll hear controversy about the efficacy of the intranasal flu vaccine (FluMist)...due to new CDC evidence. It suggests the intranasal vaccine is now only about 3% effective in kids and teens...compared to about 63% with the injectable.
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Consultant 360 Metabolic Disease Articles July 2016
Metabolic Disease Articles from our Partners at Consultant 360
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Prescriber's Letter July 2016
Infectious Diseases: You'll see more hepatitis C treated in primary care. Hep C now kills more Americans than any other infectious disease...and about half of hep C patients don't know they're infected. Consider screening for, and managing, hep C...just like you would for heart disease, diabetes, etc.
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Consultant 360 Metabolic Disease Articles June 2016
Metabolic Disease Articles from our Partners at Consultant 360
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Prescriber's Letter June 2016
Cardiology: You'll see a more individualized approach for how long to use aspirin PLUS another antiplatelet after a coronary stent. We're used to seeing most of these patients get dual antiplatelet therapy (DAPT) for 12 months...often aspirin 81 mg plus clopidogrel.
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Consultant 360 Metabolic Disease Articles May 2016
May 2016 Metabolic Disease Related News from our Partners at Consultant 360
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Prescriber's Letter May 2016
OPIOIDS: You'll see stronger efforts to limit opioid use for pain...due to new FDA warnings and CDC prescribing guidelines. Product labeling will contain new, FDA-required boxed warnings for SHORT-acting opioids about abuse, overdose, etc...similar to those already in place for LONG-acting opioids.
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Consultant 360 Metabolic Disease Articles April 2016
Metabolic Disease Articles from our Partners at Consultant 360
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Prescriber's Letter April 2016
GASTROENTEROLOGY:Bad press about dementia and other side effects will raise more questions about appropriate use of PPIs (omeprazole, etc). PPIs are popular because they're so effective and heartburn is common. But up to 70% of PPI use is unnecessary.
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Consultant 360 Metabolic Disease Articles March 2016
Consultant 360 Metabolic Disease Articles March 2016
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Prescriber's Letter March 2016
Cardiology: A shift in thinking about the CV benefits of ARBs will lead to more use of ARBs instead of ACE inhibitors. We're used to using ACEIs...since they have more CV outcomes data and SEEMED to have a bigger impact on CV events than ARBs.
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Consultant 360 Metabolic Disease Articles February 2016
Consultant 360 Metabolic Disease Articles February 2016
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Prescriber's Letter February 2016
What are the new warnings about the SGLT2 inhibitors? Do the SGLT2 inhibitors cause bone fractures, genital yeast infections, urinary tract infections, acute renal failure, or ketoacidosis?
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Consultant 360 Metabolic Disease Articles January 2016
Consultant 360 Metabolic Disease Articles January 2016
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Prescriber's Letter January 2016
You'll hear controversy about whether it makes sense to aim for a LOWER systolic blood pressure in hypertensive patients.
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Consultant 360 Metabolic Disease Articles December 2015
Consultant 360 Metabolic Disease Articles December 2015
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Prescriber's Letter December 2015
Diabetes patients will need your help sticking with metformin...since about 1 in 3 patients will have GI problems with it. We know metformin is our go-to med for type 2s...due to well-established safety and efficacy, possible CV benefits, and low cost. Plus it seems safer than previously thought in stable renal insufficiency. But GI side effects can lead to poor adherence.
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Consultant 360 Metabolic Disease Articles November 2015
Consultant 360 Metabolic Disease Articles November 2015
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Prescriber's Letter November 2015
You'll hear cautious optimism about cardiovascular benefits with the SGLT2 inhibitor, Jardiance (empagliflozin). Until now, metformin seemed to be the only diabetes med linked to a reduction in cardiovascular events in patients with type 2 diabetes. But new evidence suggests that Jardiance also reduces CV risk. This is a surprise...and has researchers perplexed about the mechanism of CV benefit. But it's likely NOT due to A1C lowering. Don't be too quick to jump on the Jardiance bandwagon.
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Consultant 360 Articles October 2015
October 2015 Metabolic Disease Related News from our Partners at Consultant 360
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Prescriber's Letter October 2015
The new PCSK9 inhibitor, Repatha (rih-PATH-ah, evolocumab), will raise questions about how to help patients stick with a statin. Repatha is similar to Praluent (alirocumab). Both PCSK9 inhibitors are injectable biologics...may lower LDL about 60%...cost about $14,000/yr...and lack long-term outcome and safety data.
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Consultant 360 Articles September 2015
September 2015 Metabolic Disease Related News from our Partners at Consultant 360
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Prescriber's Letter September 2015
You'll hear lots of buzz about Entresto (en-TRESS-toh), a new drug for systolic heart failure. It's the first "angiotensin receptor neprilysin inhibitor" (ARNI)...and combines valsartan with sacubitril (sah-KYOO-bih-tril).
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Consultant 360 Articles August 2015
August 2015 Metabolic Disease Related News from our Partners at Consultant 360
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Prescriber's Letter August 2015
Antithrombotics
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Consultant 360 Articles July 2015
July 2015 Metabolic Disease Articles from Consultant360
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Prescriber's Letter July 2015
DIABETES MEDICATION SAFETY
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Prescriber's Letter June 2015
Individualizing metformin add-ons in patients with type 2 diabetes
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Consultant 360 Articles June 2015
We are pleased to announce that PCMG has recently begun collaborating with Consultant360, a medical resource website. With this collaboration, the most up to date articles related to metabolic diseases will be posted here.
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Prescriber's Letter May 2015
The American Diabetes Assn will endorse more drug combo choices for patients with type 2 diabetes.
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Prescriber's Letter April 2015
Toujeo - What is the concentrated U-300 insulin, Toujeo (insulin glargine)?
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Prescriber's Letter March 2015
Metformin used more in patients with kidney disease.
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Prescriber's Letter January 2015
You’ll get questions about which insulin syringes or pen needles to use. Ask what the patient prefers...and use these rules of thumb. Length. Feel comfortable using the shortest needle available. PEN needles come as short as 4 mm. But insulin SYRINGE needles are at least 6 mm...to extend past the vial’s rubber stopper.
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Prescriber's Letter December 2014
Trulicity (TRUE-lih-sih-tee, dulaglutide) is another GLP-1 agonist for type 2 diabetes...after Byetta, Bydureon, Tanzeum, and Victoza. These injectables will become more popular because they can lead to weight loss...and they rarely cause hypoglycemia.
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Prescriber's Letter November 2014
Contrave (CON-trave) will compete with Belviq (lorcaserin) and Qsymia (phentermine/topiramate ER) for weight loss. Contrave contains bupropion to suppress appetite...plus naltrexone to decrease food cravings. None of these new meds are a “magic bullet”...but they can help some patients adhere to a weight-loss diet.
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Prescriber's Letter October 2014
Jardiance (jar-DEE-ans, empagliflozin) will be the third SGLT2 inhibitor...after Invokana (canagliflozin) and Farxiga (dapagliflozin). These “flozins” increase glucose excretion by inhibiting sodium-glucose co-transporter 2 (SGLT2) in the kidney. They all lower A1C by about 0.7% to 1%...reduce weight by 4 to 7 pounds...lower systolic BP by 3 to 5 mmHg...and rarely cause hypoglycemia. But these drugs have downsides.
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Prescriber's Letter September 2014
You’ll hear more about higher doses of statins increasing diabetes risk...partly due to reports of lawsuits in the lay press. Help put this into perspective for patients.
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Prescriber's Letter August 2014
Tanzeum (TAN-zee-um, albiglutide) will be another GLP-1 agonist for diabetes...after Byetta, Victoza, and Bydureon. These injectables will continue to gain popularity because they cause weight loss...and are unlikely to cause hypoglycemia.
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Prescriber's Letter July 2014
Insulin errors are leading to emergency visits and poor outcomes. Almost 100,000 emergency visits a year are for insulin-related errors or hypoglycemia...and one-third result in hospitalization. Mix-ups are a common reason for ER visits.
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Prescriber's Letter June 2014
Questions often come up about how to safely use ACEIs or ARBs in patients with chronic kidney disease. We know these meds slow the progression of kidney disease. But blocking angiotensin can reduce kidney filtration...and sometimes lead to a bump in serum creatinine (SCr) and potassium. Think of ACEIs and ARBs as the "beta-blockers of the kidney." Expect increases in SCr just as you expect beta-blockers to decrease heart rate. Although the NUMBERS may look worse, the kidneys will be better off.
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Prescriber's Letter May 2014
Which meds can actually increase the risk of developing diabetes? We know that many drugs can cause hyperglycemia...but only some increase diabetes risk. Watch for chronic use of the bigger culprits...especially in a patient already at risk for diabetes.
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Prescriber's Letter April 2014
You'll see more emphasis on improving care of diabetes patients while also improving performance on quality measures. Type 2 diabetes is still on the rise...but prognosis is improving.
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Prescriber's Letter March 2014
You'll hear debate about how to manage hypertension in diabetes patients...due to new JNC 8 hypertension guidelines.
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Prescriber's Letter February 2014
New hypertension guidelines mean you'll hear controversy about when it's acceptable to aim for HIGHER blood pressure goals. We're used to aiming for < 140/90 mmHg in most patients...and < 130/80 in patients with diabetes or kidney disease.
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Prescriber's Letter January 2014
You'll hear a lot about the new ACC/AHA cholesterol guidelines that focus MORE on statins...LESS on non-statins...and ABANDON LDL goals. We've all been taught to aim for LDL targets...such as < 100 mg/dL.
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Prescriber's Letter December 2013
DYSLIPIDEMIA - You'll start to see more lipid drugs get indications based on HARD clinical outcomes...such as reducing MI or stroke risk. Drugs are often approved just due to their ability to improve SURROGATE endpoints...lipids, blood pressure, glucose, etc.
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Prescriber's Letter November 2013
Experts will debate whether gliptins (Onglyza, etc) increase cardiovascular risk in patients with type 2 diabetes. Gliptins are popular because they're taken orally once a day...and rarely cause hypoglycemia or weight gain. In fact, nearly one in four diabetes patients take a gliptin.
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Prescriber's Letter October 2013
You'll see three new versions of the flu vaccine this season...quadrivalent, cell culture, and recombinant vaccines.
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Prescriber's Letter September 2013
You'll see big changes as key parts of the Affordable Care Act (ACA) are implemented on January 1. Starting in 2014, "Obamacare" will require most U.S. citizens to enroll in a health plan or pay a penalty.
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The Journal of the American Board of Family Medicine September-October 22 (5): 507-512 (2009) ©
Effectiveness of Cinnamon for Lowering Hemoglobin A1C in Patients with Type 2 Diabetes: A Randomized, Controlled Trial. Paul Crawford, MD. Posted with permission from Journal of The American Board Of Family Medicine.
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