Blogs

January Blog - GLP1s and risk of retinopathy

By Courtney Cameron posted 01-27-2024
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Glucagon-like peptide-1 receptor agonists (GLP-1RA) and Diabetic Retinopathy Prepared by: Emily Short, PharmD, PGY-1 Pharmacy Resident, Boston Medical Center What is diabetic retinopathy? Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus and is one of the most common causes of vision loss worldwide among individuals aged 25 to 74 years. 1 In 2021, the Centers for Disease Control and Prevention (CDC) estimated about 9.6 million people across the United States had been diagnosed with diabetic retinopathy, of which 1.84 million have vision-threatening DR. 2 The development of DR in patients with diabetes occurs ...
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October Blog - SGLT2i in surgery

By Courtney Cameron posted 10-28-2023
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Title: Management of SGLT2i in Patients with Diabetes Preparing for Surgery Author: Vivian Tran, PharmD Candidate 2024, University of Rhode Island School of Pharmacy Reviewer: Courtney Cameron, PharmD, BCACP Background The management of diabetes is often complex, involving a combination of lifestyle changes, pharmacologic therapy, and even surgical interventions. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are recommended for patients with type 2 diabetes and established ASCVD or multiple risk factors for ASCVD. These agents have also shown efficacy and mortality benefit in patients with heart failure and chronic ...
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August Blog - GLP1s in history of cholelithiasis

By Courtney Cameron posted 08-29-2023
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Title : Use of GLP1-RAs in patients with a history of cholelithiasis Author: Sarah Hughes, PharmD Candidate 2024 University of Rhode Island, School of Pharmacy Reviewer: Courtney Cameron, PharmD, BCACP Background Cholelithiasis, also known as gallstones, are hardened collections of bile materials such as cholesterol or bilirubin that collect at the bottom of the gallbladder. The size of a gallstone can vary and most of the time, they do not cause an issue until they get loose and travel into the bile ducts. When a gallstone gets loose it can travel through the bile ducts to the liver or the small intestine causing an obstruction ...
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May Blog: Asian American and Pacific Islander (AAPI) Heritage Month

By Katelyn O'Brien posted 05-17-2023
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Impact and Trends of Type 2 Diabetes in the AAPI Community Prepared by Reshana Homma, PharmD (2023 grad from Northeastern University) Reviewed by Katelyn O'Brien, PharmD, BCPS, CDCES, BC-ADM AAPI Heritage Month Asian American and Pacific Islander (AAPI) Heritage Month is observed during the month of May in the United States to celebrate the influence, history, and cultural diversity of Asian Americans and Pacific Islanders. It offers an opportunity to promote understanding of the experiences and achievements of the AAPI community while also raising awareness of the specific challenges they face. 1 As clinicians, it is essential for us to be ...
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March Blog - World Kidney Day

By Katelyn O'Brien posted 03-09-2023
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Enhancing Kidney Care for People with Diabetes: Tips for DCES in Practice Andrew Bzowyckyj, PharmD, BCPS, CDCES Background: The standards of care in diabetes are continually evolving as new science and evidence emerges, which ultimately enhances the overall quality of care for people living with diabetes. Admittedly, this can be a lot to keep up with as a practicing Diabetes Care & Education Specialist (DCES)! Although helping patients achieve their glucose targets is critical for preventing complications, a broader person-centered approach to diabetes care & education rooted in the ADCES7 Self-Care Behaviors™ is essential to help patients ...
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January ADCES Blog Post – ADA 2023 Standards of Care: Changes to LDL Recommendations

By Katelyn O'Brien posted 01-16-2023
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January ADCES Blog Post – ADA 2023 Standards of Care: Changes to LDL Recommendations Greetings Pharmacy COI Members – January marks a new year and a new set of guidelines from the American Diabetes Association. For the first blog post of the year, I wanted to highlight some notable changes to the LDL/statin recommendations found in Section 10: Cardiovascular Disease and Risk Management https://doi.org/10.2337/dc23-S010 Standard Recommendation ADA 2022 ADA 2023 Primary Prevention 10.19 For patients with diabetes aged 40–75 years without atherosclerotic cardiovascular disease, use moderate-intensity statin therapy ...
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December Blog Post: Tirzepatide, Worth the Weight?

By Katelyn O'Brien posted 12-21-2022
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Tirzepatide: worth the weight Prepared by: Ana Safri, PharmD PGY2 Ambulatory Care Resident, Boston Medical Center Reviewed by: Katelyn O'Brien, PharmD, BCPS, CDCES, BC-ADM and Courtney Cameron, PharmD What is tirzepatide? Tirzepatide (Mounjaro) is the first in its class peptide that activates both glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. Both GIP and GLP-1 are incretin hormones released in response to nutrient uptake in the gut, however GIP is responsible for ~2/3 of the total effect, allowing a synergistic effect with tirzepatide’s mechanism. Similar to other GLP-1, GIP stimulates insulin ...
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August Blog: Out with the old, in with the new: Lilly to discontinue glucagon emergency kits

By Katelyn O'Brien posted 08-22-2022
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Out with the old, in with the new: Lilly to discontinue glucagon emergency kit. How to use: https://uspl.lilly.com/glucagon/glucagon.html#ug As you can see there are many steps to preparing a glucagon kit – time is of the essence in an emergency situation! With more modern and ready-to-use glucagon options now available, Lilly will be discontinuing the old, red Glucagon Emergency Kit (GEK) in all markets. The phase out will begin December 31, 2022. The generic GEK will still be available from Amphastar Pharmaceuticals . What is Glucagon? Glucagon is a hormone the human body produces to prevent low blood sugar—but in people with diabetes, ...
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June Blog Post: T2DM Management complicated by gastroparesis

By Katelyn O'Brien posted 06-15-2022
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T2DM management complicated by gastroparesis Prepared by: Courtney Cameron, PharmD, PGY2 Ambulatory Care Pharmacy Resident, Boston Medical Center. Reviewed by: Katelyn O'Brien, PharmD, BCPS, CDCES Clinical Pharmacy Specialist, Boston Medical Center. What is diabetic gastroparesis? Gastroparesis is an autonomic neuropathic complication that more commonly affects individuals with T1DM or longstanding T2DM and may occur as a result of damaged nerves within the enteric nervous system. 1,2 It is estimated that 20-50% 3 of individuals with diabetes are affected by gastroparesis, while 30% of individuals with gastroparesis have comorbid diabetes 4 . Gastroparesis ...
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April Blog post, round 2: Ozempic 2mg

By Katelyn O'Brien posted 04-13-2022
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FDA approves 2mg dose of Ozempic (semaglutide) for T2DM Titration: 0.25mg weekly x 4 weeks (to avoid GI side effects) 0.5mg weekly as maintenance dose, if tolerating after 4 weeks and need additional glucose control, may increase to 1mg weekly. After 4 weeks if tolerating, may increase to 2mg weekly. Dosage forms: 2mg/1.5mL pen: 0.25mg or 0.5mg doses 4mg/3mL pen: 1mg doses 8mg/3mL pen: 2mg doses Trial Data – SUSTAIN FORTE:Efficacy and Safety of once weekly semaglutide 2mg vs 1mg in patients with T2DM; double blind, randomized trial In the SUSTAIN FORTE trial, people with an average starting A1C of 8.9% treated with Ozempic ® 2 mg achieved a ...
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April Blog Post - Diabetes and Ramadan

By Katelyn O'Brien posted 04-03-2022
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Diabetes and Ramadan - 2021 Practical Guidelines from International Diabetes Federation (IDF) and the Diabetes and Ramadan International Alliance (DAR) https://www.daralliance.org/daralliance/idf-dar-practical-guidelines-2021/#:~:text=A%20cornerstone%20of%20managing%20diabetes,episodes%20of%20low%20blood%20glucose . ADCES Fasting Tip Sheet: https://www.diabeteseducator.org/docs/default-source/practice/educator-tools/fasting_tip_sheet.pdf?sfvrsn=2 When is Ramadan: Saturday April 2- Sunday May 1 What is Ramadan: a holy month for Muslims during which time the consumption of food or drink is forbidden between dawn and dusk Iftar: sunset meal ...
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March Blog: Cardiorenal Benefits of Finerenone in the Treatment of Diabetic Kidney Disease

By Nicholas Messinger posted 03-27-2022
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Cardiorenal Benefits of Finerenone in the Treatment of Diabetic Kidney Disease Allyson Ellsworth, PharmD Candidate, Class of 2023, Ben and Maytee Fisch College of Pharmacy Lourdes Cross, PharmD, BCACP, CDCES, Sullivan University College of Pharmacy & Health Sciences Both type 2 diabetes (T2D) and chronic kidney disease (CKD) are becoming increasingly prevalent within the United States. Currently, over twenty million adults have T2D, and 20-40% of these patients are expected to develop some form of CKD. 1 Further, kidney disease development plays a role in increased cardiovascular (CV) disease. Finerenone is a novel nonsteroidal, ...
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Considerations for Management of Alpelisib Induced Hyperglycemia

By Katelyn O'Brien posted 02-09-2022
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Prepared by: Devin Yu, PharmD Candidate 2022 Northeastern University Katelyn O'Brien, PharmD, BCPS, CDCES Boston Medical Center Considerations for Management of Alpelisib Induced Hyperglycemia HR-Positive, HER2-Negative Breast Cancer Breast cancer is one of the most common cancers in women, affecting approximately 250,000 women in the US and 1,000,000 women in the 8 major markets ++ . 1-9 About 73% of these patients are diagnosed with HR-positive, HER2-negative disease. Alpelisib and PI3K mutations Because the treatment landscape for HR-positive, HER-2-negative breast cancer continues to show significant and persistent unmet need, newer ...
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Management of Latent Autoimmune Diabetes in Adults

By Lourdes Cross posted 11-29-2021
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Management of Latent Autoimmune Diabetes in Adults Samantha Copley, PharmD Candidate 2022 Lourdes Cross, PharmD, BCACP, CDCES Sullivan University College of Pharmacy & Health Sciences Background Latent autoimmune diabetes in adults (LADA) is an understudied form of diabetes with features of both type 1 diabetes (T1D) and type 2 diabetes (T2D). According to recent studies, LADA may account for 2%-12% of all diabetes diagnoses in adult populations. 1 LADA is a slow-progressing form of autoimmune diabetes. 2 Similar to T1D, LADA can occur when pancreatic β-cells stop producing adequate insulin, most likely due to some "insult" that slowly damages those ...
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Tirzepatide: Gaining Ground in the Diabetes World

By Lourdes Cross posted 09-29-2021
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Tirzepatide: Gaining Ground in the Diabetes World Nebile Cayan, PharmD Candidate 2022 1 Keishla Chevere Espada, PharmD Candidate 2022 1 Abigail Henry, PGY1 Community-Based Pharmacy Resident 1 Kam Capoccia, Clinical Professor of Community Care 1 1 Western New England University College of Pharmacy and Health Sciences Background Tirzepatide (LY3298176) is a novel dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist being investigated for the treatment of type 2 diabetes and chronic weight management. Tirzepatide is also being studied as a potential treatment for nonalcoholic steatohepatitis. 1 ...
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Upcoming: Targeting Inceptor for Diabetes Therapy

By Lourdes Cross posted 08-30-2021
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Upcoming: Targeting Inceptor for Diabetes Therapy Payton Waltz, PharmD PGY1 Pharmacy Resident Sullivan University College of Pharmacy and Health Sciences, Louisville, KY Welcome to the celebration for the 100 th year of insulin therapy! In 1921, Frederick Banting, Charles Best, and John MacLeod all played a hand at discovering the use of insulin therapy in patients with diabetes. 1 According to the National Diabetes Statistics Report of 2020, 10.5% of the U.S. population had diabetes and 34.5% were classified as patients with prediabetes. 2 This disease, affecting the insulin-producing islet cells of the pancreas, impacts a large percentage of this country’s ...
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Hepatitis B Vaccine in Older Individuals with Type 2 Diabetes

By Lourdes Cross posted 06-18-2021
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Hepatitis B Vaccine in Older Individuals with Type 2 Diabetes Lourdes Cross, PharmD, BCACP, CDCES Key Takeaways HBsAg/CpG (Heplisav-B) is a single-antigen hepatitis B vaccine with a immunostimulatory sequence adjuvant administered as 2 doses, 1 month apart. HBsAg/CpG provides higher rates of seroprotection against hepatitis B virus versus 3-dose HBsAg/alum (Engerix-B) in patients aged 60-70 years with type 2 diabetes. Adverse events and deaths are comparable in both groups. Introduction Although hepatitis B is a vaccine-preventable disease, hepatitis B virus (HBV) infection remains a major public health issue. Adults with diabetes are at ...
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Stop the Madness of Glucocorticoid-Induced Hyperglycemia! A Brief Review

By Lourdes Cross posted 05-25-2021
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Stop the Madness of Glucocorticoid-Induced Hyperglycemia! A Brief Review Steven Perzanowski, PharmD Candidate 2021 1 Alicia Len, PharmD Candidate 2021 1 Kam Capoccia, PharmD, BCPS, CDCES, Professor of Community Care 1 1 Western New England University College of Pharmacy and Health Sciences Incidence Glucocorticoids have many indications for both acute and chronic disease states and are associated with increased risk for glucocorticoid-induced hyperglycemia in people with and without diabetes. It’s estimated that about 40%-50% of all inpatient consults to endocrinology service are for new or worsening diabetes caused by glucocorticoid initiation. 1 ...
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Once Weekly Insulin Icodec Article Review

By Lourdes Cross posted 04-30-2021
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Once Weekly Insulin Icodec Article Review Austin Rich, PharmD, Sullivan University College of Pharmacy & Health Sciences In an article by Julio Rosenstock, et al, published in the New England Journal of Medicine on September 22, 2020, results of a phase 2 clinical trial comparing weekly insulin icodec to daily insulin glargine were reported. The goal of this study was to investigate the efficacy and safety of insulin icodec weekly injections compared to insulin glargine daily injections for initial insulin therapy in patients with type two diabetes mellitus (T2DM). There was a total of 247 participants included in the trial. Key inclusion criteria include ...
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Tame the Pain: Pharmacotherapy for Diabetic Neuropathy

By Lourdes Cross posted 02-28-2021
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Tame the Pain: Pharmacotherapy for Diabetic Neuropathy Long Phan, PharmD, Walgreens Lourdes Cross, PharmD, Sullivan University College of Pharmacy and Health Sciences Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. An estimated 7% to 10% of patients newly diagnosed with type 2 diabetes and up to 50% in patients with long-term diabetes (>25 years duration) have neuropathy. 1 DPN is a leading cause of disability, foot ulceration, and amputations. It also increases the risk for gait instability, falls, anxiety, depression, and sleep disturbances. 2 The aim of this review is to discuss pharmacotherapy options based ...
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