ACP Diabetes Monthly
Welcome to this month's issue of ACP Diabetes Monthly, an update for internists published by the American College of Physicians.
In the News for the month of June 2016
New clinical guidelines recommend bariatric surgery for obese patients with type 2 diabetes
Bariatric surgery should be recommended for type 2 diabetes patients with class III obesity, regardless of glycemic control, and those with class II obesity who have inadequately controlled hyperglycemia despite lifestyle and optimal medical therapy, the guidelines said. More...
Intensive glycemic treatment may be common, doubles risk of hypoglycemia
Intensive treatment was defined as use of more glucose-lowering medications than recommended by practice guidelines and was found in 18.7% of clinically complex Medicare patients. More...
Excess mortality examined in older patients with diabetes
Excess mortality associated with diabetes was highest in patients younger than age 75 who had had diabetes for a longer time period, with the relative hazard highest in women, a study found. More...
MKSAP quiz: Diagnosed in the ED
This month's quiz asks readers to evaluate a 66-year-old man with a random blood glucose level of 211 mg/dL, an HbA1c of 7.8%, and recent polyuria and polydipsia. More...
Alert on canagliflozin and amputations
An ongoing clinical trial found an increase in leg and foot amputations, mostly affecting the toes, in patients treated with canagliflozin (Invokana, Invokamet), according to an FDA safety alert. More...
Practice transformation resource for diabetes care updated
The National Diabetes Education Program has updated its online resource Practice Transformation for Physicians and Health Care Teams. More...
Spotlight on predicting cardiovascular events
Predicting cardiovascular events in patients with type 2 diabetes was the focus of multiple recent studies. More...
Physician editor: David V. O'Dell, MD, FACP
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About ACP Diabetes Monthly
ACP Diabetes Monthly is a monthly newsletter produced by the staff of ACP Internist. It is automatically sent to all College members who have an e-mail address on file with ACP.
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A 62-year-old man is evaluated for declining exercise capacity over the past year. He was diagnosed with moderate COPD 3 years ago. His symptoms had previously been well controlled with tiotropium and as-needed albuterol. He has not had any hospitalizations. He is adherent to his medication regimen, and his inhaler technique is good. Following a physical exam and review of previously performed chest radiographs and pulmonary function testing, what is the most appropriate management?
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