March 27th 2025
Mean reduction in HbA1c was nearly 1% after transition from MDI plus CGM to Omnipod 5 in the first randomized trial to evaluate the shift in mode of insulin delivery.
The Shared Burden of Type 2 Diabetes
May 4th 2010Dr Rutecki makes some excellent points about the costs of diabetes care and how the reduction of complications such as myocardial infarction, heart failure, and renal disease will decrease costs and suffering. But I have difficulty with the tone of his comments that seem to shift blame for the cause of these costs.
Reducing Cost-Related Medication Nonadherence in Patients With Diabetes
April 16th 2010In the United States, it has been estimated that 7.8% of the total population has diabetes. In 2007, the direct medical expenditures for diabetes were about $116 billion and the total direct and indirect costs were $174 billion, according to the CDC.1
Podcast: Group Visits for Diabetes: How to Help Patients Better Control Their Disease
March 23rd 2010Only 7% of patients with diabetes have reached goals for hemoglobin A1c, LDL cholesterol, and blood pressure. What can be done to help more patients achieve their goals? In this 2-part interview, Dr Edward Shahady shows how group visits can help your patients with diabetes better control their disease and reduce their risk of diabetic complications.
Predicting the Risk of Type 2 Diabetes: When Does the Clock Start Ticking?
March 3rd 2010American medicine is undergoing the greatest financial scrutiny in its history. The hue and cry for reform stems primarily from the soaring costs of health care. However, placing the blame for these costs solely on increased utilization of technology, cutting-edge pharmaceuticals, cost-shifting hospitals, and physicians misses a bigger mark.
Diabetes Drugs Fell in the Doughnut Hole
February 18th 2010The gap in Medicare prescription drug coverage, or the doughnut hole, may be why many seniors with diabetes are not adhering to medications. Researchers from Kaiser Permanente and the David Geffen School of Medicine at the University of California, Los Angeles, focused their study on what happens during the gap, or when patients are paying for their medications out of pocket.1
The authors are affiliated with the University of Mississippi School of Pharmacy, in University, Miss. Dr Yang is assistant professor in the department of pharmacy administration.
Diabetes and Cardiovascular Disease: Does Lowering Hemoglobin A1c Help or Harm?
November 3rd 2009Case 1: Mr A. is a 55-year-old man who comes to your office for a routine physical examination. He is a traveling salesman and has recently gained weight. He does not exercise much and is a frequent visitor to fastfood establishments. His father had “a touch of diabetes” and died of a myocardial infarction (MI) at age 59.
Reducing the Complications of Type 1 Diabetes: A Job Well Done
November 3rd 2009Chronic diseases and multiple comorbid conditions can be a frustrating part of any primary care day. Health care professionals work hard and are long overdue to see the “fruits” of their many labors. One area in which progress and personal satisfaction have been particularly slow in coming is the day-to-day management of diabetes.
Evolving Therapy for Type 2 Diabetes Complications
August 18th 2009The past 3 decades have seen a profound paradigmatic shift in the treatments available for type 2 diabetes mellitus. Because the disease is complicated by a variety of macrovascular and microvascular pathologies, interventions must be broad-based (tight glycemic and blood pressure [BP] control, serum lipid and urinary protein reductions). This "multifactorial" approach has proven successful.
Barriers to Effective Diabetes Care: How to Recognize and Overcome
August 17th 2009Diabetes is the most demanding chronic illness. It challenges every fiber of a patient’s body and spirit and demands a system of care that ministers to the biological, social, and psychological aspects of the illness. It takes a “village” to accomplish this task.
Intensive Glycemic Control Reduces Cardiac Risk in Patients With Type 2 Diabetes Mellitus
August 2nd 2009The results of a meta-analysis indicate that intensive glycemic control significantly reduces the risk of coronary events in patients with type 2 diabetes mellitus. The meta-analysis, conducted by Ray and colleagues,1 included 5 randomized controlled trials that compared intensive with standard glucose-lowering regimens in more than 33,000 patients. The general treatment protocols are shown in the Table.
Stamp Out Inefficiency in Diabetes Management
May 8th 2009I recommend having a “diabetes stamp” made up that includes in its imprint fasting blood glucose, low-density lipoprotein cholesterol, hemoglobin A1c, urine microalbumin, ECG, eye examination, podiatric examination, flu shot, and pneumococcal vaccine-along with lines on which to write dates and results.
Painful Diabetic Peripheral Neuropathy: Options for Treatment
April 30th 2009New treatment options for pain caused by diabetic peripheral neuropathy were presented at the annual meeting of the American Academy of Neurology. While oral medications from 2 different drug classes appear effective, injection of botulinum toxin does not.
Retinal Vein Occlusions:5 Cases That Run the Gamut
April 2nd 2009A 58-year-old man sought medical attention because of the recent sudden onset of blurred vision in his left eye. His vision had not improved over several days. The patient had hypertension and had recently sustained a myocardial infarction. He was taking metoprolol, 25 mg/d, and aspirin, 81 mg/d.
Insulin: A Possible Treatment for AD?
March 14th 2009Researchers at Northwestern University, Evanston, Ill, report that insulin, by shielding memory-forming synapses from injury, may slow or prevent the damage and memory loss caused by amyloid b–derived diffusible ligands (ADDLs)-toxic neuroproteins associated with Alzheimer disease (AD). Findings of the study, which provides additional evidence that AD may be caused by a new, third form of diabetes, were published in the February 10 issue of the Proceedings of the National Academy of Sciences of the United States of America.
Diabetes Management: An Approach That Improves Outcomes and Reduces Costs
April 2nd 2008As many as 10% of Americans older than 20 years have type 2 diabetes, and more than 20% of the total population has the metabolic syndrome. Type 2 diabetes will develop in many of those with the metabolic syndrome.
Effective Diabetes Care: Closing In on an Elusive Goal
April 2nd 2008As the numbers of patients with diabetes continue to climb, physicians and health policy experts are devoting increasing attention to strategies that can improve care for these patients. One of the strategies frequently mentioned is the Chronic Care Model, developed in 1998 by the MacColl Institute for Healthcare Innovation.
For Better Glucose Monitoring, Attack the Finger on the Flank
April 2nd 2008Most patients who self-monitor their blood glucose levels stick the lancet into the finger pad to obtain a drop of blood for the glucometer. A more effective strategy is to stick the side of the finger instead. The sides are the most vascular areas on the finger, making it easier to obtain blood.
The Future of Inhaled Insulin Therapy
February 1st 2008Diabetes is a destructive disease that kills thousands eachyear in the United States and disables thousands more, and its incidence hasbeen rising dramatically. Glycemic control is imperative to forestallcomplications; however, it can be difficult for patients to achieve glycemicgoals.
Diabetes: A Primer on New Drug Options
November 1st 2007Over the past 20 years, the treatment armamentarium for diabetes has greatly expanded: 8 different classes of non-insulin drugs and 8 different types of insulin are now available. The newer classes of agents include disaccharidase inhibitors, thiazolidinediones, meglitinides, glucagonlike peptide analogs, and dipeptidyl peptidase IV inhibitors.