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February 2013 Briefing - Diabetes & Endocrinology

Here are what the editors at HealthDay consider to be the most important developments in Diabetes & Endocrinology for February 2013. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Hyperbaric Oxygen No Benefit for Diabetic Foot Ulcers

THURSDAY, Feb. 28 (HealthDay News) -- For patients with diabetic foot ulcers, use of hyperbaric oxygen (HBO) is not associated with improved healing or with a decrease in the likelihood of amputation, according to a study published online Feb. 19 in Diabetes Care.

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Glycemic Control Not Linked to Adverse Outcomes After TKA

THURSDAY, Feb. 28 (HealthDay News) -- For patients undergoing total knee arthroplasty, diabetes (with or without poor glycemic control) is not associated with adverse surgical outcomes, according to research published online Feb. 27 in The Journal of Bone & Joint Surgery.

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Glucagonlike Peptide 1-Based Tx Increases Pancreatitis Risk

THURSDAY, Feb. 28 (HealthDay News) -- Use of glucagonlike peptide 1 (GLP-1)-based therapies (GLP-1 mimetic, exenatide, and dipeptidyl peptidase 4 inhibitor, sitagliptin phosphate) correlates with increased likelihood of hospitalization for acute pancreatitis among adults with type 2 diabetes, according to a study published online Feb. 25 in JAMA Internal Medicine.

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Variation ID'd in Increased Demand for Primary Care Docs

THURSDAY, Feb. 28 (HealthDay News) -- Although the anticipated increased demand for primary health care providers with implementation of the Affordable Care Act is unlikely to be disruptive overall, considerable variation exists in the proportional demand for additional primary care providers, according to research published online in the February issue of Health Affairs.

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Overall Sedentary Time Shows Major Cardiometabolic Impact

THURSDAY, Feb. 28 (HealthDay News) -- For patients with known risk factors for type 2 diabetes mellitus, sedentary time is detrimentally linked to cardiometabolic health markers, and may be a more important indicator than moderate-to-vigorous physical activity, according to research published online Feb. 27 in Diabetologia.

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CMS Issues Final Rule on Physician Sunshine Act

THURSDAY, Feb. 28 (HealthDay News) -- The Centers for Medicare and Medicaid Services (CMS) have issued a final rule requiring drug and device manufacturers and group purchasing organizations (GPOs) to report payment or gifts of more than $10 to physicians, hospitals, and other providers, and necessitating manufacturers and GPOs to report ownership or investment interests held by physicians or their family members.

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Predictors of Mortality, CVD Risk in Cushing's Disease ID'd

THURSDAY, Feb. 28 (HealthDay News) -- A number of factors, including the duration of glucocorticoid exposure, older age at diagnosis, and preoperative adrenocorticotropic hormone (ACTH) concentration, are associated with a higher risk of mortality in patients treated for Cushing's disease (CD), according to research published online Feb. 7 in the Journal of Clinical Endocrinology & Metabolism.

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Artificial Pancreas Provides Tight Glucose Control in Youth

WEDNESDAY, Feb. 27 (HealthDay News) -- The use of an artificial pancreas system yields less hypoglycemia and tighter control of nocturnal glucose levels in children, compared to a sensor-augmented pump system, according to a study published in the Feb. 28 issue of the New England Journal of Medicine.

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Home-Based Telehealth Not Effective for Chronic Conditions

WEDNESDAY, Feb. 27 (HealthDay News) -- Second-generation, home-based telehealth is no more effective than usual care for quality of life and psychological outcomes among patients with chronic health conditions, according to research published online Feb. 26 in BMJ.

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High-Fat Diet Impairs Satiation Signaling in Obese-Prone

WEDNESDAY, Feb. 27 (HealthDay News) -- Feeding obese-prone rats a high-fat diet leads to impaired satiation signaling through glucagon-like peptide-1 (GLP-1), a gastrointestinal hormone that suppresses food intake and helps regulate energy balance, according to a study published online Feb. 19 in Diabetes.

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Preparation Underway for Implementation of ACA in 2014

TUESDAY, Feb. 26 (HealthDay News) -- As the implementation of the Affordable Care Act (ACA) nears, states are preparing for some of its provisions, including expanded access to Medicaid and the Children's Health Insurance Program (CHIP) and the use of information technology, according to a report issued by the Kaiser Family Foundation.

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Sleep Restriction Impacts Gene Regulation

TUESDAY, Feb. 26 (HealthDay News) -- Insufficient sleep affects gene regulation, including genes associated with circadian rhythms, sleep homeostasis, oxidative stress, and metabolism, according to a study published online Feb. 25 in the Proceedings of the National Academy of Sciences.

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Immune Intervention Reduces β-Cell Death in Type 1 Diabetes

MONDAY, Feb. 25 (HealthDay News) -- Patients recently diagnosed with type 1 diabetes have greater death of pancreatic β-cells compared with patients with long-standing diabetes, which can be reduced by treatment with teplizumab, according to a study published online Feb. 19 in Diabetes.

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USPSTF: Vitamin D, Calcium Supplements Don't Prevent Fx

MONDAY, Feb. 25 (HealthDay News) -- For non-institutionalized postmenopausal women, the U.S. Preventive Services Task Force (USPSTF) recommends against daily supplementation with ≤400 IU of vitamin D3 and ≤1,000 mg of calcium for primary prevention of fractures, and a lack of evidence impairs the provision of recommendations for other populations, according to a statement published online Feb. 26 in the Annals of Internal Medicine.

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Bariatric Surgery Does Not Appear to Cut Health Care Costs

MONDAY, Feb. 25 (HealthDay News) -- Bariatric surgery does not appear to reduce health care costs over a six-year period, according to an analysis published online Feb. 20 in JAMA Surgery.

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Mental Health and Substance Use Disorder Benefits Expanded

FRIDAY, Feb. 22 (HealthDay News) -- In a final rule, which will make purchasing health coverage easier for consumers, mental health and substance use benefits will be expanded to 62 million Americans, according to a report published Feb. 20 by the U.S. Department of Health and Human Services.

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Hands-On Cooking Education Aids Docs' Nutrition Knowledge

FRIDAY, Feb. 22 (HealthDay News) -- Continuing education that includes didactic and hands-on cooking sessions improves physicians' self-reported nutrition-related behaviors, according to a research letter published online Feb. 18 in JAMA Internal Medicine.

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Fast Food Accounts for >11 Percent of Daily Calories in U.S.

FRIDAY, Feb. 22 (HealthDay News) -- More than 11 percent of adults' daily calorie consumption comes from fast foods, according to a February data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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CDC: Children's Caloric Intake Decreased in Last Decade

THURSDAY, Feb. 21 (HealthDay News) -- Over the last decade, caloric intake has fallen for most age groups among children and adolescents in the United States, according to a February data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS). In addition, protein intake has generally increased and carbohydrate intake has generally decreased.

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CMS Proposes Payment and Policy Updates for 2014

THURSDAY, Feb. 21 (HealthDay News) -- Payment and policy updates have been proposed for 2014, according to the Centers for Medicare and Medicaid Services (CMS) Advanced Notice and draft Call Letter published Feb. 15.

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Report Discusses Impact of ACGME 2011 Requirements

THURSDAY, Feb. 21 (HealthDay News) -- Although many residency program directors approve of individual components within the Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements introduced in 2011, less than half express overall approval, according to a perspective piece published in the Feb. 21 issue of the New England Journal of Medicine.

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Faster Adoption of Electronic Health Records Needed

WEDNESDAY, Feb. 20 (HealthDay News) -- The adoption of electronic health records (EHRs) by health providers for Medicare is increasing, but not quickly enough to avoid penalties in 2015, according to a letter published in the Feb. 21 issue of the New England Journal of Medicine.

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Women's Awareness of Heart Disease Improving

WEDNESDAY, Feb. 20 (HealthDay News) -- Over the past 15 years there has been an improvement in women's awareness of cardiovascular disease (CVD), but racial disparity still exists, according to a study published online Feb. 19 in Circulation.

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Anti-Müllerian Hormone Levels Can Predict IVF Success

WEDNESDAY, Feb. 20 (HealthDay News) -- A woman's plasma level of anti-Müllerian hormone (AMH), produced in the ovaries, is strongly associated with the rate of live birth after in vitro fertilization (IVF) and may serve as a prognostic factor for the chance of pregnancy and live birth, according to a study published online Feb. 13 in the Journal of Clinical Endocrinology & Metabolism.

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Two Endocrine Disruptors Linked to Osteoarthritis

WEDNESDAY, Feb. 20 (HealthDay News) -- Higher serum concentrations of two endocrine disrupting chemicals, perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS), are associated with nearly twice the risk of osteoarthritis in women, but not men, according to research published online Feb. 14 in Environmental Health Perspectives.

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Birth Order May Affect Metabolic, Cardiac Risk

TUESDAY, Feb. 19 (HealthDay News) -- Birth order may influence metabolic and cardiovascular disease risk factors, including insulin sensitivity and daytime blood pressure, according to a study published online Jan. 30 in the Journal of Clinical Endocrinology & Metabolism.

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CMS: Unnecessary Medicare Regulations to Be Reformed

TUESDAY, Feb. 19 (HealthDay News) -- Medicare regulations which are unnecessary, obsolete, or excessively burdensome on hospital or health care providers will be reformed, according to a rule proposed by the Centers for Medicare & Medicaid Services (CMS) in response to the President's instructions in Executive Order 13563.

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Multimodality Approach Needed to Reengineer Health Care

TUESDAY, Feb. 19 (HealthDay News) -- A multimodality approach focusing on reengineering the U.S. health care system may provide a way to improve quality and reduce costs, according to a viewpoint published in the Feb. 20 issue of the Journal of the American Medical Association.

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Artificial Intelligence Can Improve Patient Care

TUESDAY, Feb. 19 (HealthDay News) -- Use of an artificial intelligence (AI) framework can improve patient outcomes at one-third of the costs of the current standard of care, according to a study published online Jan. 2 in Artificial Intelligence in Medicine.

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Vitamin D Dosing Should Be Same in Black, White Women

MONDAY, Feb. 18 (HealthDay News) -- Black and white women respond similarly to vitamin D supplements and should be dosed similarly, according to a study published online Feb. 5 in the Journal of Clinical Endocrinology & Metabolism.

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A1C, Blood Pressure, LDL Goals Improving in Diabetes

FRIDAY, Feb. 15 (HealthDay News) -- Although there have been improvements in achieving hemoglobin A1c (A1C), blood pressure (BP), and low-density lipoprotein (LDL) cholesterol (ABC) goals, control is still suboptimal for many, including minorities, according to a study published online Feb. 15 in Diabetes Care.

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Health Care-Associated Infections Decreased in 2011

FRIDAY, Feb. 15 (HealthDay News) -- In 2011, decreases were noted for some health care-associated infections (HAIs), according to a report prepared by the U.S. Centers for Disease Control and Prevention.

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Cell Phone Cameras Improve Self-Reported Dietary Recall

FRIDAY, Feb. 15 (HealthDay News) -- Pictures taken on cell phone-based digital cameras can function as a memory prompt to more accurately recall fruit and vegetable intake, according to a study published in the February issue of Applied Nursing Research.

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Physician Beliefs About Obesity Impact Nutritional Counseling

FRIDAY, Feb. 15 (HealthDay News) -- Physicians' beliefs about diet-related causes of obesity impact the nutritional counseling they provide for their patients, according to a study published online Feb. 8 in Preventive Medicine.

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Estrogen May Improve Pathway-Selective Insulin Resistance

THURSDAY, Feb. 14 (HealthDay News) -- Estrogen treatment at the time of surgical menopause may reverse aspects of pathway-selective insulin resistance in the liver associated with a high-fat diet (HFD) in mice by promoting insulin action on glucose metabolism but limiting hepatic lipid deposition, according to a study published in the February issue of Diabetes.

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Psychological, Sexual Impact of Female Breadwinners Explored

THURSDAY, Feb. 14 (HealthDay News) -- For couples in which the wife earns more than the husband, there may be psychological and sexual implications, according to a study published in the March issue of the Personality and Social Psychology Bulletin.

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IOM Urges International Action to Eradicate Fake Drugs

THURSDAY, Feb. 14 (HealthDay News) -- Falsified and substandard medications pose public health problems around the world, and international action should be taken to combat the phenomenon, according to a report published Feb. 13 by the Institute of Medicine (IOM).

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Oregon Experiment Will Provide Insight Into ACO-Based Reform

WEDNESDAY, Feb. 13 (HealthDay News) -- The outcome of the Oregon experiment, an ambitious program centered on a model of an accountable care organization (ACO), will offer important lessons for the wider implementation of ACOs as cost-saving mechanisms, according to a perspective piece published online Feb. 13 in the New England Journal of Medicine.

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Post-Pregnancy Deterioration in Glycemic Control in T1DM

WEDNESDAY, Feb. 13 (HealthDay News) -- Women with type 1 diabetes experience post-pregnancy deterioration in glycemic control and sustained weight gain, according to research published online Dec. 18 in Diabetes Care.

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Consumer Advocates Urge FDA to Set Sugar Limits for Soda

WEDNESDAY, Feb. 13 (HealthDay News) -- Consumer advocates and nutrition experts, led by the Center for Science in the Public Interest (CSPI), are petitioning the U.S. Food & Drug Administration to determine what levels of high-fructose corn syrup and other sweeteners in sodas and soft drinks are indeed safe.

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Selumetinib Ups Radioiodine Uptake in Thyroid Cancer

WEDNESDAY, Feb. 13 (HealthDay News) -- The mitogen-activated protein kinase (MAPK) kinase (MEK) 1 and MEK2 inhibitor selumetinib generates clinically meaningful increases in iodine uptake and retention in patients with radioiodine-refractory thyroid cancer, according to a study published in the Feb. 14 issue of the New England Journal of Medicine.

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Health Insurance Exchanges Are Top Priority on U.S. Agenda

WEDNESDAY, Feb. 13 (HealthDay News) -- The public's health care agenda places creation of a health insurance exchange or marketplace as a top priority, according to a report published by the Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health.

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Diabetes Practice Patterns, Knowledge Gaps Identified

WEDNESDAY, Feb. 13 (HealthDay News) -- Practice patterns and knowledge gaps vary for health care providers (HCPs) who manage patients with type 2 diabetes, although most patients receive evidence-based care, according to research published in the Winter issue of Clinical Diabetes.

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Gradual Dietary Sodium Reductions Will Save Lives

TUESDAY, Feb. 12 (HealthDay News) -- Substantial health benefits can likely be achieved if Americans gradually reduce their daily dietary sodium intake over the next decade, according to research published online Feb. 11 in Hypertension.

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Potency of OTC Vitamin D Supplements Varies Widely

TUESDAY, Feb. 12 (HealthDay News) -- The potency of over-the-counter (OTC) and compounded vitamin D (cholecalciferol) supplements vary widely, according to a research letter published online Feb. 11 in JAMA Internal Medicine.

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Red Meat Intake May Raise Risk of Gestational Diabetes

TUESDAY, Feb. 12 (HealthDay News) -- Higher consumption of red meat is associated with an increased risk of gestational diabetes mellitus (GDM), according to research published online Feb. 1 in Diabetes Care.

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Progressive Exercise Training May Benefit Diabetic Neuropathy

MONDAY, Feb. 11 (HealthDay News) -- In a rat model of diabetes, exercise is associated with decreased diabetes-associated neuropathic pain, which correlates with increased expression of heat shock protein 72 (Hsp72), according to a study published in the February issue of Anesthesia & Analgesia.

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Creatinine Excretion Rate Linked to Higher Mortality in T2DM

MONDAY, Feb. 11 (HealthDay News) -- In patients with type 2 diabetes and nephropathy, a lower creatinine excretion rate (CER) is associated with higher all-cause mortality, according to research published online Jan. 8 in Diabetes Care.

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Increasing Patient Activation Tied to Lower Health Care Costs

MONDAY, Feb. 11 (HealthDay News) -- Patient activation is associated with improved outcomes and lower health care costs, according to a review published in the February issue of Health Affairs.

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Final HIPAA Omnibus Rule Goes Into Effect March 26

FRIDAY, Feb. 8 (HealthDay News) -- The final omnibus rule, which makes changes to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, goes into effect March 26, and physicians must be in compliance by Sept. 23.

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Most Dietary Supplement Use Not Recommended by Docs

FRIDAY, Feb. 8 (HealthDay News) -- Adults frequently use dietary supplements, including multivitamins, calcium, and omega-3 or fish oil, to improve or maintain their health, and less than one-quarter of this use is on the basis of health care provider recommendation, according to research published online Feb. 4 in JAMA Internal Medicine.

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Long-Acting Daily Opioids Increase Risk of Hypogonadism

FRIDAY, Feb. 8 (HealthDay News) -- For men with chronic pain taking opioids on a daily basis, hypogonadism occurs significantly more frequently in those taking long-acting opioids (LAOs) compared with short-acting opioids (SAOs), according to a study published online Jan. 24 in the Clinical Journal of Pain.

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Most Youth With Type 1 Diabetes Don't Meet HbA1c Goals

FRIDAY, Feb. 8 (HealthDay News) -- Most children with type 1 diabetes (T1D) have hemoglobin A1c (HbA1c) values above target levels, according to a study published online Jan. 22 in Diabetes Care.

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High hsCRP May Up Risk of Macular Edema in T1DM

FRIDAY, Feb. 8 (HealthDay News) -- For patients with type 1 diabetes mellitus, elevated levels of high-sensitivity C-reactive protein (hsCRP) are associated with an increased risk of clinically significant macular edema (CSME) and with the development of retinal hard exudates, according to a study published online Feb. 7 in JAMA Ophthalmology.

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Less Benefit for Obese With Lumbar Disc Herniation Tx

THURSDAY, Feb. 7 (HealthDay News) -- Obese patients derive less benefit from both operative and non-operative lumbar disc herniation treatment, according to a study published in the Jan. 2 issue of The Journal of Bone & Joint Surgery.

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n-3 PUFA May Reduce Markers of Kidney Disease in T2DM

THURSDAY, Feb. 7 (HealthDay News) -- In patients with type 2 diabetes and evidence of kidney injury, supplementation with n-3 long-chain polyunsaturated fatty acids (PUFA) does not reduce urine albumin excretion but is associated with a reduction in certain markers of kidney injury, according to research published online Dec. 28 in Diabetes Care.

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For Female Nurses, Working Nights Tied to Increased BMI

THURSDAY, Feb. 7 (HealthDay News) -- Female nurses working night or mixed shifts have higher body mass index (BMI) scores compared with nurses who work regular daytime schedules, according to a study published in the February issue of Applied Nursing Research.

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Baseline Factors Impact Lifestyle Intervention Success

THURSDAY, Feb. 7 (HealthDay News) -- Certain baseline characteristics better predict successful weight loss with the Diabetes Prevention Program (DPP) lifestyle intervention, according to a study published in the January issue of Diabetes Care.

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Midway Waist Circumference Better Than Iliac Crest Measure

WEDNESDAY, Feb. 6 (HealthDay News) -- Waist circumference measured midway (WC-mid) between the lowest ribs and the iliac crest better defines risks associated with central obesity than does waist circumference measured at the iliac crest (WC-IC), according to a study published online Dec. 28 in Diabetes Care.

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Physicians' Pay for Existing Patients Dropped in 2012

TUESDAY, Feb. 5 (HealthDay News) -- Physicians' pay for existing patients dropped considerably in 2012, according to the results of the Fee Schedule Survey published Jan. 31 in Physicians Practice.

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Health-Plan, Employer-Based Programs Studied for Diabetes

TUESDAY, Feb. 5 (HealthDay News) -- Health plan-initiated, employer-based wellness programs are being implemented to test new approaches to help reduce diabetes risk and, more broadly, to prevent chronic illness, according to research published online Jan. 31 in Preventing Chronic Disease.

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FSMB: Approaches Explored for Expediting Multi-State Licenses

MONDAY, Feb. 4 (HealthDay News) -- New approaches are being explored for streamlining physician multi-state licensure to accommodate the use of telemedicine in the delivery of health care, according to a report from a meeting held from Jan. 16 to 17 by the Federation of State Medical Boards (FSMB).

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Predictors of Higher Diabetes Health Care Costs Identified

MONDAY, Feb. 4 (HealthDay News) -- The average five-year cost of caring for patients with diabetes is higher for those with abnormal kidney function, suboptimal glycemic control, and presence of proteinuria, according to research published online Dec. 13 in Diabetes Care.

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IT Improves Pediatric Obesity Screening and Treatment

MONDAY, Feb. 4 (HealthDay News) -- Health information technology (IT) can improve pediatric obesity screening rates and treatment, but the effect on weight loss and other outcomes is less clear, according to a study published online Feb. 4 in Pediatrics.

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Grape Polyphenols Counteract Fructose-Induced Effects

FRIDAY, Feb. 1 (HealthDay News) -- Grape polyphenol (PP) supplementation prevents fructose-induced oxidative stress and insulin resistance in healthy volunteers with high metabolic risk, according to research published online Dec. 28 in Diabetes Care.

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Medroxyprogesterone Acetate Linked to Immune Suppression

FRIDAY, Feb. 1 (HealthDay News) -- Use of the injectable contraceptive depot medroxyprogesterone acetate (MPA), common in areas such as sub-Saharan Africa with high HIV-1 prevalence, is associated with suppression of the immune response, according to a study published online Jan. 25 in Endocrinology.

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Low Adiponectin in First Trimester Linked to GDM

FRIDAY, Feb. 1 (HealthDay News) -- Low adiponectin levels during the first trimester of pregnancy correlate with a higher level of insulin resistance and an increased risk of developing gestational diabetes mellitus (GDM), according to research published online Jan. 8 in Diabetes Care.

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