Candis M. Morello, PharmD, CDE
Research Interests
Research Team with Jan Hirsch
• Exploring clinical outcomes in
diabetes patients
• Director, Diabetes Intense
Medical Management Clinic,
VASDHS
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DIMM Clinic Managers Team
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Ginger Lo, Class of 2018
Mandy Leung, Class of 2018
Jennifer Vu, Class of 2017
Carmen Truong, Class of 2017
Clinical and Long Term Outcomes
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Andrea Bechthold, Class of 2014
John Khoan, Class of 2016
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Patient Satisfaction Outcomes
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Medication Adherence Outcomes
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Sandy Chong, Class of 2014
Crystal Zhou, Class of 2015
Pharmacoeconomic Outcomes
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David Ha, Class of 2012
Christine Cadiz, Class of 2012
Mark Bounthavong, PharmD
Andrew Zimmerman, Class of 2015
Medication & Comorbid Complexity
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John Khoan, Class of 2016
Taylor Rotunno, Class of 2016
Clinical Care:
Finding the Best Combo with the Patient
Brain: GLP-1 analogs,
amylin analog (satiety)
Muscles and tissues: TZD,
Metformin (insulin sensitivity),
Insulin (peripheral glucose uptake)
Liver:
Metformin, Insulin, GLP-1
analogs, amylin analog,
DPP-4 Inh (↓ Hepatic
glucose output)output)
Stomach:
GLP-1 analogs and
amylin analog (slows
gastric emptying)
Gut:
GLP-1 agonist, analog
Kidneys:
SGLT-2 inh (increases
glucose urinary output)
Mouth: GLP-1 analogs, amylin
analog (reduced caloric intake)
Pancreas/Alpha cells: GLP-1
analogs, amylin analog , DPP-4 Inh
( postprandial glucagon
secretion)
Pancreas/Beta cells:
SFU, Glinides (insulin secretion)
GLP-1 analogs, DPP-4 Inh (glucosedependent insulin secretion)
Gut:
AGI /BAS (delays CHO
breakdown/absorption)
Image developed from images at: www.topnews.in/healthcare/node?page=12, www.jamesgillespiesps.ik.org,
www.beyondbiology.org/beyondbiology.org/index on 6/18/10.Revised 6/9/14 CMMorello
MTM Spider Web©
Individualized Clinical Care
MEDICATION
MONITORING,
ADRS
COMPLICATIONS
FINANCES
MEDICATION
ADHERENCE
MEDICATION
COMPLEXITY
LIVING
SITUATION
MOTIVATING
FACTORS
WEIGHT
SODIUM
INTAKE
LEGAL
ISSUES
ELECTROLYES
DPN
USE OF TOBACCO,
EtOH, ILLICIT DRUGS
FOOT CARE
AMPUTATIONS
GLYCEMIC
CONTROL
DIABETES
PHYSICAL
ACTIVITY
MICROALBUMINERIA
PVD
FUNGAL
INFECTIONS
VISION
CHANGES
BACTERIAL
INFECTIONS
QUALITY &
QUANITITY
OF FOOD
CULTURAL BELIEFS
& PREFERENCES
COOKING
GROCERIES
NOCTURIA,
BLURRY
VISION, LOW
ENERGY
HYPOGLYCEMIA
PERSON WITH
RENAL STATUS
NEPHROPATHY
SOCIOECONOMIC
AND BEHAVIORAL
CLINICAL
READINESS
TO CHANGE
ACCESS
TO CARE
RETINOPATHY
BLINDNESS
Adapted from Morello CM, Hirsch J, Lee KC. Navigating the complexity of patients through an innovative tool: The MTM Spider Web. JAPhA.2013; 53(5):53
Use of the MTM Spider Web© is protected by U.S. copyright laws. Permission for use is required by primary author at andismorello@ucsd.e
Proposed Collaborations with SSPPS Faculty
General
Associated Conditions
• Diabetes treatments
• Diabetes prevention
• Inflammatory impact on
diabetes
• Medication therapy
management
• Medication complexity
• Pharmacoeconomic impact
• Geriatrics
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Cardiovascular
Lipids
Hypertension
Neuropathy
Retinopathy
Nephropathy
Wound healing
Depression
Hypothyroidism