Month: August 2016

SGLT-2 Webinar on Demand

August 18, 2016

SGLT-2 Webinar on Demand

Diabetes Series LiveHere’s the Link to the Webinar.

Description:

SGLT-2 Inhibitors in the Treatment of Type 2 Diabetes: Methodology and Monitoring Impact

Speakers

 

Richard Beaser, MD

Associate Professor of Medicine

Harvard Medical School

 

 

Nuha El Sayed, MD

Director-International Training Programs

Joslin Diabetes Center

PROGRAM INFO

Topics Of Interest

•

The role of the kidney as a treatment target for glycemic control of type 2 diabetes

•

The mechanism of action and indications of use of sodium-glucose cotransporter-2 (SGLT-2) inhibitors

•

Strategies to assess the risk/benefit ratio of SGLT-2 inhibitors for their optimal and safe utilization

•

Patient assessment, methods for initiation and titration and adverse effect monitoring for appropriate integration of SGLT-2 inhibitors as part of a therapeutic strategy for type 2 diabetes

Jointly provided by Primary Care Network and PlatformQ Health Education, LLC.

This session has been approved for 1.0 AMA PRA Category 1 Credit™.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Primary Care Network and PlatformQ Health Education, LLC. Primary Care Network is accredited by the ACCME to provide continuing medical education for physicians.

Tuition

Complimentary

Credit Designation Statements

Live Online Activity

Primary Care Network designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Online On-Demand Enduring Material

Primary Care Network designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

All other health care professionals will be issued a certificate of participation.

Primary Care Network has been awarded Accreditation with Commendation (2013-2019) by the Accreditation Council for Continuing Medical Education (ACCME).

 

New in Type 2

August 16, 2016

New in Type 2

stomach-1051854_640In an article in Diabetes Care, we have a report on a new method for controlling type 2.

“The gastrointestinal tract plays a major role in the physiologic regulation of glucose metabolism, so it is plausible that gastrointestinal changes in response to years of exposure to certain foods might contribute to the development of metabolic diseases, especially type 2 diabetes. There is now a solid biological rationale to consider the gastrointestinal tract as an ideal target for anti-diabetes interventions.  In fact, recently recognized new guidelines from international diabetes organizations recommend the use of gastrointestinal surgery as a standard treatment option in certain patients with type 2 diabetes.  However, because surgery is not suitable as mass treatment for the hundreds of millions of patients suffering from diabetes, less invasive approaches that harness the mechanisms of major surgery and reproduce some of its beneficial effects could provide a real opportunity for improvement of diabetes care. The early results with Revita DMR are quite encouraging in this regard,” said Dr. Francesco Rubino of London’s King’s College Hospital.

Anti-Monsanto

August 10, 2016

monsanto-152587_640Many people knowledgeable about food production systems are concerned about the power of large corporations that provide our food.  This site is critical of Monsanto.

FODMAPS Works for IBS

August 10, 2016

Nutr Clin Pract. 2015 Oct;30(5):665-82. doi: 10.1177/0884533615569886. Epub 2015 Feb 18.

Role of FODMAPs in Patients With Irritable Bowel Syndrome

Abstract

BACKGROUND & AIMS:

A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) often is used to manage functional gastrointestinal symptoms in patients with irritable bowel syndrome (IBS), yet there is limited evidence of its efficacy, compared with a normal Western diet. We investigated the effects of a diet low in FODMAPs compared with an Australian diet, in a randomized, controlled, single-blind, cross-over trial of patients with IBS.

METHODS:

In a study of 30 patients with IBS and 8 healthy individuals (controls, matched for demographics and diet), we collected dietary data from subjects for 1 habitual week. Participants then randomly were assigned to groups that received 21 days of either a diet low in FODMAPs or a typical Australian diet, followed by a washout period of at least 21 days, before crossing over to the alternate diet. Daily symptoms were rated using a 0- to 100-mm visual analogue scale. Almost all food was provided during the interventional diet periods, with a goal of less than 0.5 g intake of FODMAPs per meal for the low-FODMAP diet. All stools were collected from days 17-21 and assessed for frequency, weight, water content, and King’s Stool Chart rating.

RESULTS:

Subjects with IBS had lower overall gastrointestinal symptom scores (22.8; 95% confidence interval, 16.7-28.8 mm) while on a diet low in FODMAPs, compared with the Australian diet (44.9; 95% confidence interval, 36.6-53.1 mm; P < .001) and the subjects’ habitual diet. Bloating, pain, and passage of wind also were reduced while IBS patients were on the low-FODMAP diet. Symptoms were minimal and unaltered by either diet among controls. Patients of all IBS subtypes had greater satisfaction with stool consistency while on the low-FODMAP diet, but diarrhea-predominant IBS was the only subtype with altered fecal frequency and King’s Stool Chart scores.

CONCLUSIONS:

In a controlled, cross-over study of patients with IBS, a diet low in FODMAPs effectively reduced functional gastrointestinal symptoms. This high-quality evidence supports its use as a first-line therapy.

CLINICAL TRIAL NUMBER:

ACTRN12612001185853.

 

Clin Exp Gastroenterol. 2016 Jun 17;9:131-42. doi: 10.2147/CEG.S86798. eCollection 2016.

Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date.

Abstract

This review summarizes the published clinical studies concerning the management of irritable bowel syndrome (IBS) using restriction of Fermentable Oligosaccharide, Disaccharide, Monosaccharide, and Polyols in the diet (low FODMAP diet). In recent years, the data supporting low FODMAP diet for the management of IBS symptoms have emerged, including several randomized controlled trials, case-control studies, and other observational studies. Unlike most dietary manipulations tried in the past to alleviate gastrointestinal symptoms of IBS, all studies on low FODMAP diet have consistently shown symptomatic benefits in the majority of patients with IBS. However, dietary adherence by the patients and clear dietary intervention led by specialized dietitians appear to be vital for the success of the diet. Up to 86% of patients with IBS find improvement in overall gastrointestinal symptoms as well as individual symptoms such as abdominal pain, bloating, constipation, diarrhea, abdominal distention, and flatulence following the diet. FODMAP restriction reduces the osmotic load and gas production in the distal small bowel and the proximal colon, providing symptomatic relief in patients with IBS. Long-term health effects of a low FODMAP diet are not known; however, stringent FODMAP restriction is not recommended owing to risks of inadequate nutrient intake and potential adverse effects from altered gut microbiota. In conclusion, the evidence to date strongly supports the efficacy of a low FODMAP diet in the treatment of IBS. Further studies are required to understand any potential adverse effects of long-term restriction of FODMAPs.

Nutr pubmed Pract. 2013 Jun;28(3):300-6. doi: 10.1177/0884533613485790. Epub 2013 Apr 24.

Extending our knowledge of fermentable, short-chain carbohydrates for managing gastrointestinal symptoms.

Abstract

The Monash University low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet is now accepted as an effective strategy for managing symptoms of irritable bowel syndrome (IBS) in Australia, with interest expanding across the world. These poorly absorbed, short-chain carbohydrates have been shown to induce IBS symptoms of diarrhea, bloating, abdominal pain, and flatus due to their poor absorption, osmotic activity, and rapid fermentation. Four clinical trials have been published to date, all with significant symptomatic response to the low FODMAP diet. Up to 86% of patients with IBS have achieved relief of overall gastrointestinal symptoms and, more specifically, bloating, flatus, abdominal pain, and altered bowel habit from the approach. This review provides an overview of the low FODMAP diet and summarizes the research to date, emerging concepts, and limitations. FODMAPs are known to be beneficial to bowel health; the importance of this and how this should be considered in the clinical management of IBS is also discussed. A clinical management flowchart is provided to assist nutrition professionals in the use of this approach.