Poor Numeracy Is Common and Might Be Associated with Worse Glycemic Control
General Medicine Summary and Comment
Many patients with diabetes had trouble understanding insulin titration instructions, marking units accurately on insulin syringes, and calculating carbohydrate intakes.
Lifestyle Interventions Lower Diabetes Incidence Decades Later
General Medicine Summary and Comment
Among patients with impaired glucose tolerance, diet and exercise interventions for 6 years lowered the cumulative incidence of diabetes at 20 years and delayed onset of the disease.
By Bruce Soloway, MD
June 26, 2008
Covering:
Li G et al., Lancet 2008 May 24; 371:1783
Thiazolidinediones and Fracture Risk in Diabetic Women
Women's Health Summary and Comment
Fracture risk was higher in diabetic women treated with thiazolidinediones than in those taking other antidiabetic drugs.
By Diane E. Judge, APN/CNP
June 26, 2008
Covering:
Kahn SE et al., Diabetes Care 2008 May; 31:845
Meier C et al., Arch Intern Med 2008 Apr 28; 168:820
Erectile Dysfunction: A New Risk Factor for Heart Disease
Cardiology Summary and Comment
Results of two new studies make a strong case for including ED in cardiovascular risk assessment.
By Howard C. Herrmann, MD
June 25, 2008
Covering:
Gazzaruso C et al., J Am Coll Cardiol 2008 May 27; 51:2040
Ma RC et al., J Am Coll Cardiol 2008 May 27; 51:2045
Kloner RA., J Am Coll Cardiol 2008 May 27; 51:2051
USPSTF Concludes Current Evidence Is Insufficient to Screen for Gestational Diabetes
General Medicine Clinical Practice Guideline Watch
But other organizations recommend screening women who have risk factors.
By Richard Saitz, MD, MPH, FACP, FASAM
June 24, 2008
Covering:
Hillier TA et al., Ann Intern Med 2008 May 20; 148:766
U.S. Preventive Services Task Force., Ann Intern Med 2008 May 20; 148:759
Depression and Diabetes: Each Increases Risk for the Other
Psychiatry Summary and Comment
Results from a large prospective study
Gestational Diabetes Is Increasing in the U.S.
General Medicine Summary and Comment
Increases were seen among both whites and blacks in all age groups and in all regions of the U.S.
By Robert W. Rebar, MD
June 19, 2008
Covering:
Getahun D et al., Am J Obstet Gynecol 2008 May; 198:525.e1
HHV-8 and Diabetes in Africa
Infectious Diseases Summary and Comment
A diabetic syndrome in sub-Saharan Africans appears to be linked to human herpesvirus 8 infection.
Early Intensive Insulin Can Induce Remission in Type 2 Diabetes
General Medicine Summary and Comment
Free
Insulin therapies induced 1-year remission more often than did oral hypoglycemic agents.
By Bruce Soloway, MD
June 17, 2008
Covering:
Weng J et al., Lancet 2008 May 24; 371:1753
More Olive Oil, Please: Mediterranean Diet and Type 2 Diabetes Prevention
General Medicine Summary and Comment
Adherence to a Mediterranean diet was associated with lower diabetes risk.
How Relevant Are Clinical Trials to Clinical Practice?
Cardiology Summary and Comment
Not very, at least when it comes to patient-important outcomes in diabetes, according to an analysis of endpoints listed in three trial registries
Accounting for the High Rates of Diabetes in Schizophrenia
Psychiatry Summary and Comment
To what extent do family risk factors, the psychiatric disease itself, or medications predispose patients with schizophrenia to diabetes mellitus?
By Joel Yager, MD
June 9, 2008
Covering:
Koponen H et al., Acta Psychiatr Scand 2008 May; 117:337
Saddichha S et al., Acta Psychiatr Scand 2008 May; 117:342
Does Tight Glycemic Control Prevent Cardiovascular Events in Type 2 Diabetic Patients?
General Medicine Summary and Comment
Free
In two trials, tight glycemic control had no significant effect on macrovascular events.
By Allan S. Brett, MD
June 6, 2008
Covering:
Patel A et al., N Engl J Med 2008 Jun 6
Gerstein HC et al., N Engl J Med 2008 Jun 6
The ACCORD and ADVANCE Trials: Implications for Patients with Type 2 Diabetes
Cardiology Summary and Comment
Free
Interventions that produced improvements in microvascular measures did not produce improvements in patient-important outcomes.
By Harlan M. Krumholz, MD, SM
June 6, 2008
Covering:
Patel A et al. for the ADVANCE Collaborative Group., N Engl J Med 2008 Jun 6
Gerstein HC et al. for the Action to Control Cardiovascular Risk in Diabetes Study Group., N Engl J Med 2008 Jun 6
Aliskiren to Reduce Proteinuria in Diabetic Nephropathy
General Medicine Summary and Comment
Aliskiren in combination with an angiotensin-receptor blocker has a moderate additive effect in reducing proteinuria in patients with diabetic nephropathy.
By Allan S. Brett, MD
June 4, 2008
Covering:
Parving H-H et al., N Engl J Med 2008 Jun 5; 358:2433
Beyond Blood Pressure Control: Targeting Proteinuria with Renin-Angiotensin-Aldosterone Inhibitors
Cardiology Summary and Comment
Free
A combination of aliskiren and losartan reduced albuminuria in patients with type 2 diabetes and nephropathy — at least in the short term.
By Joel M. Gore, MD
June 4, 2008
Covering:
Parving H-H et al., N Engl J Med 2008 Jun 5; 358:2433
Ingelfinger JR., N Engl J Med 2008 Jun 5; 358:2503
Routine Self-Monitoring of Glucose in Non–Insulin-Treated Type 2 Diabetes Is Ineffective and Costly
General Medicine Summary and Comment
Furthermore, more-intensive self-monitoring had a significantly negative effect on quality of life.
Prevention of Heart Failure
Cardiology Clinical Practice Guideline Watch
Free
AHA experts summarize heart failure epidemiology, describe evidence-based preventive interventions, and outline initiatives to advance awareness and understanding.
Coexisting Conditions and Management of Hypertension
Cardiology Summary and Comment
In a population-based cohort, the more unrelated comorbidities patients had, the less likely they were to receive intensified treatment for uncontrolled hypertension.
By Joel M. Gore, MD
May 21, 2008
Covering:
Turner BJ et al., Ann Intern Med 2008 Apr 15; 148:578
Do Statins Decrease Risk for Cancer?
Cardiology Summary and Comment
A multivariate analysis of observational data suggests that some of them might.
By Joel M. Gore, MD
May 21, 2008
Covering:
Karp I et al., Am J Med 2008 Apr; 121:302
Delayed Presentation for ST-Segment-Elevation MI: Which Patients Are at Greatest Risk?
Cardiology Summary and Comment
An analysis of nationwide data profiles the most vulnerable; whether targeted interventions can improve outcomes remains to be seen.
Is Tight Glycemic Control Beneficial Perioperatively?
General Medicine Summary and Comment
In a meta-analysis, perioperative mortality was significantly lower with insulin infusions than with control interventions, but the authors have doubts about the data.
By Allan S. Brett, MD
May 13, 2008
Covering:
Gandhi GY et al., Mayo Clin Proc 2008 Apr; 83:418
Skin Biopsies in Sensory Axonal Neuropathies
Neurology Summary and Comment
Patterns of axonal and Schwann-cell degeneration may be useful both for diagnosis and for designing clinical trials of regenerative therapies.
By Jean-Michel Vallat, MD
May 13, 2008
Covering:
Ebenezer GJ et al., Brain 2007 Oct; 130:2703
Thiazolidinediones and Risk for Fractures
General Medicine Summary and Comment
In an observational study, users of TZDs had higher risk for fractures than those taking other antidiabetes medications.
Gestational Diabetes: Controversies About Diagnosis and Treatment Persist
General Medicine Summary and Comment
Increasing maternal glucose intolerance is associated with increasing birth weight, neonatal hypoglycemia, and fetal insulin levels.
By Robert W. Rebar, MD
May 7, 2008
Covering:
The HAPO Study Cooperative Research Group., N Engl J Med 2008 May 8; 358:1991
Rowan JA et al., N Engl J Med 2008 May 8; 358:2003
Ecker JL and Greene MF., N Engl J Med 2008 May 8; 358:2061
