Recently, Dr. Trippe participated in a study regarding GlycoMark. Please click here to read the study.
The results of a study on “Nutritional Management of Endothelial Dysfunction among Patients with Diabetic Peripheral Neuropathy with Metanx: Results of a Real-World Patient Experience Trial,” will appear in an upcoming issue of the Journal of Diabetes Research. Dr. Trippe was a major contributor to this study. We will post a link to the study once it is published.
Click here to view the article in PDF format: Trippe-2009-DPN the forgotten complication
A1c Control in a Primary Care Setting: Self-titrating an Insulin Analog Pre-mix (INITIATEplus Trial)
Purpose: To study glycemic control and hypoglycemia development upon initiation of insulin through a self-titration schedule in a 24-week trial, conducted with 4875 insulin-naïve patients with poorly controlled type 2 diabetes, predominantly in a primary care setting.
Methods: Subjects initiated twice-daily biphasic insulin aspart 70/30 with 6 units prebreakfast and 6 units presupper, self-titrating according to self-measured blood glucose values. Subjects were randomized (1:1:1) to telephone counseling provided by a registered dietician: no counseling (NC), 1 counseling session (1C), or 3 sessions (3C).
Results: Mean baseline HbA1c (9.9% across groups) decreased ∼2.5% to 7.49%±1.48, 7.48%±1.50, and 7.44%±1.46 in the NC, 1C, and 3C groups, respectively. Within these groups, a hemoglobin A1c (HbA1c) value <7% was achieved by 40.2%, 41.6%, and 41.8% of subjects, respectively. Eight-point blood glucose profiles were substantially improved from baseline for all groups. Hypoglycemia was experienced by 10.2%-11.4% of the subjects in each group. Rates of minor and major hypoglycemia were low but decreased as dietary counseling increased (minor hypoglycemia: 56 vs 50 vs 45 episodes per 100 patient-years; major hypoglycemia, 9 vs 6 vs 4 episodes per 100 patient-years, for the NC vs 1C vs 3C groups, respectively; P <.001, 3C vs NC). Weight increased by 3.13, 3.40, and 2.88 kg for the NC, 1C, and 3C groups, respectively.
Conclusion: In the primary care setting, self-titration of biphasic insulin aspart 70/30 was effective in achieving recommended HbA1c goals even with minimal dietary counseling.
By Bruce S. Trippe, M.D., F.A.C.E.
Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes, estimated to affect 50% of patients—approximately 4 million people in the United States alone.1-6 Its prevalence increases with the patient’s age, duration of diabetes, and poor glycemic control.7-10
View the rest of the article here: DPN Article