#ecuimres transcript

Healthcare Social Media Transcript

From: Fri Jan 11 0:00:00 PST 2013
To: Fri Jan 11 8:00:00 PST 2013

What is #ecuimres? Who were the influencers during this time period? #ecuimres analytics


Healthcare Conference  - Healthcare Tweet Chats  -  Healthcare Analytics

ecuimchiefs
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#ecuimres #grandrounds Dr. Tanenberg presents: One size no longer fits all: New goals and therapeutic options for Type 2 Diabetes"
ecuimchiefs
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#ecuimres #grandrounds Diabetes incidence is growing worldwide, not just in the US
ecuimchiefs
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#ecuimres #grandrounds Very important to recognize early because the MACROvascular complications precede other complications.
ecuimchiefs
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#ecuimres #grandrounds UKPDS study included pts who were diagnosed earlier in contrast to other landmark trials w/ pts w/ diabetes for >10y
ecuimchiefs
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#ecuimres #grandrounds 2012 ADA recommendations for Diabetes management now updated.
ecuimchiefs
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#ecuimres #grandrounds HbA1c target for young pts can be aggressive (6-6.5), <7 for middle age and <8 for elderly. ie: pt centered therapy
ecuimchiefs
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#ecuimres #grandrounds Dr T asking how many calories in supersized McD fries. Answer = 610 calories
ecuimchiefs
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#ecuimres #grandrounds Therapeutic options for diabetes grown SIGNIFICANTLY since mid 1990s (in contrast to HTN meds: new class every 10yrs)
ecuimchiefs
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#ecuimres #grandrounds Now reviewing INCRETIN
drgregharris
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Great review of GLP-1, emphasizes the role of gut in glucose management #ecuimres #grandrounds
drgregharris
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Unfortunately mess for modulation of GLP-1 are expensive #ecuimres #grandrounds
ecuimchiefs
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#ecuimres #grandrounds A1c reduction: metformin and sulfonylureas reduce by 1-1.5%
ecuimchiefs
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#ecuimres #grandrounds DPP4 and GLP1 agonists work synergistically with metformin and sulfonylureas
drgregharris
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DC metformin with GFR <30 #ecuimres #grandrounds
ecuimchiefs
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#ecuimres #grandrounds Drugs to avoid in renal disease: metformin (if GFR <40), TZDs
ecuimchiefs
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#ecuimres #grandrounds What meds help with weight? Metformin is weight neutral. GLP agonists can reduce weight
drgregharris
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Increase in BMI by 1 in the first year of diabetes diagnosis increased CV mortality by 63% #ecuimres #grandrounds
ecuimchiefs
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#ecuimres #grandrounds Stepwise approach for treatment of T2DM (pic) http://t.co/UH3V6xAY
drgregharris
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No good data on which medications to use after max metformin. #ecuimres #grandrounds
ecuimchiefs
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#ecuimres #grandrounds Expensive vs "Cheap" diabetes drugs(pic) http://t.co/HWXV0YIW
drgregharris
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Primary care docs tend to wait too long to start insulin #ecuimres #grandrounds
ecuimchiefs
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#ecuimres #grandrounds What is Clinical Inertia? Failure of healthcare providers to initiate intensive therapy when it is indicated.
ecuimchiefs
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#ecuimres #grandrounds When to start INSULIN? When combo oral/IV agents not working, intolerance, hyperglycemia in hospital, renal/liver dz
ecuimchiefs
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#ecuimres #grandrounds Do not use Insulin as a "punishment". Tell pts early that it may be inevitable so pts don't feel they have"failed"
drgregharris
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You get more hypoglycemia with NPH compared with glargine. #ecuimres #grandrounds
ecuimchiefs
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#ecuimres #diabetes How to start Insulin? Start once daily injection first (glargine) in pts who may be apprehensive abt injections/needles
ecuimchiefs
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#ecuimres #diabetes Metformin asks synergistically with Insulin
drgregharris
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GLP-1 meds approved with basal insulin only #ecuimres #grandrounds
ecuimchiefs
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#ecuimres #diabetes Reviewing data from Arnolds et al: greatest HbA1c reduction with insulin+metformin+exenatide
ecuimchiefs
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#ecuimres #diabetes Insulin pens more convenient for pts but are more expensive than vials (unless insulin use is low, then pen is cheaper)
ecuimchiefs
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#ecuimres #diabetes #grandrounds Summary slide from Dr. Tanenberg's lecture. http://t.co/X6SzCsJ9
ecuimchiefs
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#ecuimres #diabetes Audience asking abt pts on BID glargine. Dr T "higher the dose lower the absorbability" +can only give 100 units a time.
ecuimchiefs
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#ecuimres #diabetes #grandrounds Novel therapy: Phlorizin blocks SGLT2 mediated glucose reabsorption --> renal glycosuria
ecuimchiefs
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#ecuimres #diabetes #grandrounds Dapaglipfozin review: http://t.co/uFBlGQq8
acsmaggus
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MT Nice slide #ecuimres #grandrounds Stepwise approach for treatment of DM2 (pic) http://t.co/oRfe3i0v

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