Use of self-monitoring tools in a clinic sample of adults with type 2 diabetes.

Self-monitoring is an effective strategy for chronic disease management; many readily available mobile applications allow tracking of diabetes-related health behaviors but their use has not yet been integrated into routine clinical care. How patients engage with these applications in the real world is not well understood. The specific aim of this study is to survey adults with type 2 diabetes (T2D) regarding self-monitoring behaviors, including mobile application use. In 2015, we surveyed an adult diabetes clinic population (n = 96) regarding self-monitoring behaviors: diet, physical activity, weight, and blood glucose. Self-monitoring with any method ranged from 20-90 %. About half of the participants owned smartphones; few had mobile applications. The most common app-tracked behavior was physical activity, then weight and diet. Despite numerous available mobile health-tracking applications, few T2D adults from our sample used them, though many reported self-monitoring with other methods.

Prolactinoma: A Massive Effect on Bone Mineral Density in a Young Patient.

This case highlights a prolactinoma in a young male, and its impact on bone health. Osteoporosis has been noted to be an issue in postmenopausal women with prolactinomas. This case shows a similar impact on bone health in a young male resulting in low bone mineral density for age based on Z-score. This case report highlights the possible mechanisms for the bone loss in the setting of prolactinoma and the need for assessing bone health in such patients. Furthermore it highlights the need for a thorough evaluation in such patients.

Fatty liver disease in diabetes mellitus.

Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in type 2 diabetes mellitus (T2DM), likely reflecting the frequent occurrence of obesity and insulin resistance in T2DM. NAFLD also can occur in type 1 DM (T1DM), but must be distinguished from the more common glycogen hepatopathy as a cause of hepatomegaly and liver function abnormalities in T1DM. Weight reduction achieved by diet and exercise is effective in preventing and treating NAFLD in obese diabetic subjects. Bariatric surgery also has been shown to reverse NAFLD in T2DM, and recently approved weight loss medications should be evaluated for their impact on the development and progression of NAFLD. There is limited evidence suggesting that specific drugs used for blood glucose control in T2DM [thiazolidinediones (TZDs), glucagon-like peptide-1 (GLP-1) analogs, and dipeptidyl peptidase-4 (DPP-4) inhibitors] and also statins may have a role in preventing or treating NAFLD in patients with diabetes.

Thoughts on the progression of type 2 diabetes drug discovery.

INTRODUCTION: Type 2 diabetes is a growing epidemic in need of effective treatments. There has been research in recent years involving numerous drug therapies and targets. This article is a review of the progress thus far in type 2 diabetes drug discovery. AREAS COVERED: This editorial reviews type 2 diabetes drug discovery mainly over the past decade through a literature search of PubMed. Furthermore, the author reviews several avenues of research, including the expansion of knowledge for possible drug therapies involving the ß-cell, such as targeting its proliferation, function and apoptosis. This knowledge has led to possible drug therapies in clinical trials, particularly insulin secretagogues that are glucose-dependent. Other areas of research in type 2 diabetes drug discovery discussed by the author relate to the new frontier of genome-wide association studies (GWAS), the challenges of oral insulin development and drug targets of inflammation. The author also reviews sirtuin activators and resveratrol, especially its relationship to insulin resistance. EXPERT OPINION: The progression of type 2 diabetes drug discovery holds much promise, but many agents are in the nascent stages of investigation and human trials proving efficacy are needed. Furthermore, basic science research into some of these agents may need to be further elucidated before clinical trials can be initiated.

Mycobacterium chelonae vertebral osteomyelitis.

Mycobacterium chelonae is a rapidly growing mycobacterium (RGM) in Runyon group IV. This group includes all other nontuberculous mycobacterium (NTM) except the mycobacterium tuberculosis complex. The most commonly infected organ by RGM is the lung, usually in immunosuppressed patients or those with underlying lung disease. Vertebral infection is very rare. Osteomyelitis is rarely caused by M. chelonae, and only one other case of M. chelonae vertebral osteomyelitis has been reported. A case of M. chelonae vertebral osteomyelitis in a man with intravenous drug abuse is reported, and NTM osteomyelitis is reviewed with a focus on M. chelonae and appropriate treatment options for M. chelonae vertebral osteomyelitis.