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In episode 137, James and Mike welcome Mark McConnell back to podcast land to discuss the latest change in diabetes management guidelines. Mark leads us through a great discussion about how the VA has decided to do a bit of an about face, and incorporate not only evidence but also patient values and preferences into their most recent glucose control guidelines. At the end we all agree that an A1C measurement, no matter if it is 7, 8, or 9, is just a number and is not the ultimate endpoint for proper diabetes care.

Show notes

1) VA-DoD Update of Diabetes Guidelines

2) Glycemic control in type 2 diabetes: time for an evidence-based about-face?

Ann Intern Med. 2009 Jun 2;150(11):803-8. Epub 2009 Apr 20

3) The ACCORD Trial and control of blood glucose level in Type 2 diabetes mellitus

Arch Intern Med 2009;169:150-4

In episode 136, James and Mike once again raise the content bar level with the premium of all PREMIUM podcasts. We talk about a study that looked at the effect of ezetimibe plus simvastatin and we get a very clear answer but unfortunately the question that was asked was completely wrong. We then bring the podcast to a rising never ending crescendo by discussing a “pivotal” trial comparing psyllium to prunes in chronic constipation and low and behold the answer is extremely useful and relevant to day-to-day practice. 

Shownotes

1) SHARP TRIAL

Lancet 2011;377:2181-92

2) The PRUNE trial

Aliment Pharmacol Ther 2011;33:822–8

3) An Evidence-Based Approach to the Management of Chronic Constipation in North America

Am J Gastroenterol 2005;100 Suppl 1:S5-S21