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May 2013 Briefing - Diabetes & Endocrinology

Here are what the editors at HealthDay consider to be the most important developments in Diabetes & Endocrinology for May 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.

Aggressive Lowering of BP May Up Risk of CHD in Diabetes

FRIDAY, May 31 (HealthDay News) -- Aggressive lowering of blood pressure may be associated with increased risk of coronary heart disease (CHD) in black or white patients with diabetes, according to research published online May 20 in Diabetes Care.

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Patients Like Commercial Programs for Weight Loss

FRIDAY, May 31 (HealthDay News) -- Patients view being overweight in a nonmedical context, and the use of commercial providers to manage weight loss mirrors this perspective, according to research published in the May/June issue of the Annals of Family Medicine.

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Economics, Health Explain U.S. Women's Mortality Inequalities

THURSDAY, May 30 (HealthDay News) -- The widening gap in mortality across education levels seen among U.S. white women can largely be explained by economic circumstances and health behaviors, according to a study published online May 30 in the Journal of Health and Social Behavior.

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Patients Who Share in Care Decisions May Up Costs of Care

THURSDAY, May 30 (HealthDay News) -- Patient preference for participating in shared decision making regarding care may increase length of hospital stays and costs of care, according to research published online May 27 in JAMA Internal Medicine.

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2012 AMA Report Highlights Progress Toward Better Future

THURSDAY, May 30 (HealthDay News) -- Given the changes in America's health care system and challenges facing physicians, in 2012, the American Medical Association (AMA) focused on creating a better future for the nations' patients, physicians, and medical students, according to their annual report.

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For Women, Calcium Intake Tied to Reduced Mortality Risk

THURSDAY, May 30 (HealthDay News) -- Women taking up to 1,000 mg/day of calcium supplements and with increased consumption of dietary calcium may have a reduced risk of mortality, according to a study published online May 23 in the Journal of Clinical Endocrinology & Metabolism.

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One-Third of Medical Students Have Implicit Anti-Fat Bias

THURSDAY, May 30 (HealthDay News) -- More than one-third of medical students have a significant implicit anti-fat bias that few are aware of, according to a study published in the July issue of Academic Medicine.

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Doc Passengers Assist in Half of In-Flight Medical Emergencies

WEDNESDAY, May 29 (HealthDay News) -- Physician passengers provide medical assistance in about half of in-flight medical emergencies, which are most commonly related to syncope, respiratory symptoms, or gastrointestinal symptoms, according to a study published in the May 30 issue of the New England Journal of Medicine.

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Modified Genes Present After Maternal Bariatric Surgery

WEDNESDAY, May 29 (HealthDay News) -- Children born after their mothers had bariatric surgery have gene modifications that are consistent with their reduced cardiometabolic risk, according to a study published online May 28 in the Proceedings of the National Academy of Sciences.

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Transparency Key to Improving Value Care for Patients

WEDNESDAY, May 29 (HealthDay News) -- In order to ensure the provision of higher quality care and cost control in a post-Affordable Care Act health care system, data on price, utilization, and quality should be made publicly available unless there is a compelling publicly-acceptable justification for keeping it confidential, according to a study published online May 28 in the Annals of Internal Medicine.

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Enrollment in U.S. Medical Colleges Is Increasing

WEDNESDAY, May 29 (HealthDay News) -- Enrollment in U.S. medical colleges is increasing, but there is concern about the adequacy of training opportunities, according to a report published by the Association of American Medical Colleges (AAMC).

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Billions Can Be Saved With Pharmacy Benefit Management

WEDNESDAY, May 29 (HealthDay News) -- Efficient pharmacy benefit management, including increasing use of generic drugs and negotiation of market-based pharmacy dispensing fees, could save Medicaid programs billions of dollars nationwide in the next 10 years, according to a report prepared by the Menges Group and sponsored by the Pharmaceutical Care Management Association.

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HHS: End-of-2013 Targets for EHR Use Already Reached

TUESDAY, May 28 (HealthDay News) -- The U.S. Department of Health & Human Services (HHS) has already met and exceeded its goal for 50 percent of physician offices and 80 percent of eligible hospitals to have electronic health records (EHRs) by the end of 2013, according to a report published by the department.

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USPSTF Recommends Gestational DM Screening After 24 Weeks

TUESDAY, May 28 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) recommends use of the 50-g oral glucose challenge test (OGCT) for screening pregnant women for gestational diabetes mellitus (GDM) after 24 weeks of gestation. This Recommendation Statement is based on an evidence review published online May 28 in the Annals of Internal Medicine.

Draft Recommendation Statement
Comment on Recommendations
Background Review

FDA Approves A1c Test for Diabetes Diagnosis

TUESDAY, May 28 (HealthDay News) -- The U.S. Food and Drug Administration has just cleared a hemoglobin A1c assay to be marketed for the diagnosis of diabetes, according to a May 24 press release issued by the agency.

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Docs Anticipating Changes Ahead As ACA Progresses

MONDAY, May 27 (HealthDay News) -- Most physicians expect the Affordable Care Act (ACA) to continue as planned and expect further integration in the coming years, according to a report published by Deloitte.

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Depression Linked to Severe Hypoglycemia in Diabetes

FRIDAY, May 24 (HealthDay News) -- Adults with diabetes who are depressed are at increased risk for a shorter time to the first episode of severe hypoglycemia as well as a higher number of severe hypoglycemic episodes, according to a study published in the May/June issue of the Annals of Family Medicine.

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Large Number of Youth Notice Posted Fast Food Calorie Info

FRIDAY, May 24 (HealthDay News) -- More than 40 percent of youth eating at a fast food restaurant notice and sometimes use posted calorie information when making food choices, according to research published online May 22 in the Journal of Public Health.

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No Benefit of Intensive Insulin Rx in Hyperglycemia in Hospitalized

FRIDAY, May 24 (HealthDay News) -- Intensive insulin therapy (IIT) to treat hyperglycemia in hospitalized patients does not have any benefits and may cause harm, according to guidelines published online May 23 in the American Journal of Medical Quality.

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Comorbidities Common With Alopecia Areata

FRIDAY, May 24 (HealthDay News) -- Comorbid conditions often accompany alopecia areata, according to a study published online May 22 in JAMA Dermatology.

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Overweight and Obese Are More Likely to Doctor Shop

FRIDAY, May 24 (HealthDay News) -- Doctor shopping is more likely among overweight and obese individuals and is associated with a significantly increased rate of emergency department visits, according to research published online May 13 in Obesity.

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In Utero Smoke Exposure Ups Subsequent Health Risks

FRIDAY, May 24 (HealthDay News) -- In utero exposure to cigarette smoking puts women at higher risk of subsequently developing gestational diabetes or obesity in adulthood, according to a study published online May 23 in Diabetologia.

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Data Support Basing Health Decisions on Both Benefit, Cost

FRIDAY, May 24 (HealthDay News) -- Person-level health care expenditures per month of health status-adjusted life expectancy are much higher for adults aged 85 years and older than for 0- to 14-year-olds, but despite spending much more on health care, the aging population gets substantially less value for that spending in terms of quality and quantity of life expectancy, according to a study published in the Spring issue of the Michigan Journal of Public Affairs.

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About One in Four Uninsured Could Be Excluded From ACA

FRIDAY, May 24 (HealthDay News) -- More than one in four of those eligible for new premium assistance tax credits under the Affordable Care Act (ACA) do not have a checking account and will not be able to receive premiums from insurance companies, according to a report published by Jackson Hewitt.

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Studies Discuss Complications of Type 2 Diabetes in Youth

THURSDAY, May 23 (HealthDay News) -- Youth with type 2 diabetes have high rates of serious complications, with a disease trajectory that is distinct from that in adults, according to findings from the ongoing Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study published online May 23 in Diabetes Care.

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Systematic Screening of Med Adherence Will ID Barriers

WEDNESDAY, May 22 (HealthDay News) -- Implementation of systematic monitoring for medication adherence will allow for identification of barriers to adherence and tailoring of interventions, according to a viewpoint piece published in the May 22/29 issue of the Journal of the American Medical Association.

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Cardiologist Calls for Action on Added Sugars

WEDNESDAY, May 22 (HealthDay News) -- Despite evidence supporting the link between excess sugar consumption and various health issues, official bodies seem keen to question or deny this link, according to an observation piece published online May 21 in BMJ.

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CDC Presents Recent Trends in Health Behaviors of U.S. Adults

TUESDAY, May 21 (HealthDay News) -- In 2008 to 2010, the prevalence of key health behaviors among U.S. adults varied, with about one in five adults current smokers and 62.1 percent overweight or obese, according to a report presented by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Body Fat Reduction Best Predicts Exercise-Induced HbA1c Change

MONDAY, May 20 (HealthDay News) -- Reductions in central adiposity and improved fitness are the most prominent predictors of changes in hemoglobin A1c (HbA1c) after exercise training in patients with type 2 diabetes, according to a study published online May 13 in Diabetes Care.

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Digital Divide Exists With Physician EHR Adoption

MONDAY, May 20 (HealthDay News) -- The majority of physicians remain reluctant to adopt health information technology (HIT), according to a report by Deloitte Touche Tohmatsu.

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Marijuana Use Tied to Lower Fasting Insulin Level, HOMA-IR

FRIDAY, May 17 (HealthDay News) -- Marijuana use is associated with lower levels of fasting insulin and insulin resistance and with smaller waist circumference, according to a study published online May 16 in the American Journal of Medicine.

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Exercise Prevents Fructose-Induced Hypertriglyceridemia

FRIDAY, May 17 (HealthDay News) -- Moderate aerobic exercise prevents fructose-induced hypertriglyceridemia in healthy males, according to a study published online May 14 in Diabetes.

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Prednisolone Disturbs Carbohydrate Metabolism

FRIDAY, May 17 (HealthDay News) -- In patients with inflammatory diseases without diabetes, treatment with low-dose prednisolone has deleterious effects on carbohydrate metabolism, according to a study published online May 13 in Diabetes Care.

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Free Fatty Acids Linked to Cardiac Risk in Late Adulthood

THURSDAY, May 16 (HealthDay News) -- Blood levels of free fatty acids are associated with insulin resistance during young adulthood and cardiovascular risk factors in later adulthood, according to a study published online May 13 in Diabetes.

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CDC: Guidelines Reduce Blood Infections at Dialysis Facilities

WEDNESDAY, May 15 (HealthDay News) -- A set of interventions at dialysis facilities substantially reduces the rate of bloodstream infections, according to a study published online May 15 in the American Journal of Kidney Diseases.

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Hospital Hypoglycemia Rates Up in Black Men With Diabetes

TUESDAY, May 14 (HealthDay News) -- Home diabetes regimens partially explain the increased risk of having a hypoglycemia event during hospitalization among older African-American men with diabetes, according to a study published in the April issue of Clinical Diabetes.

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Passive Smoking Exposure Tied to Lower HDL-C Among Teen Girls

TUESDAY, May 14 (HealthDay News) -- For nonsmoking adolescent girls, exposure to passive smoke since birth is associated with lower levels of high-density lipoprotein cholesterol (HDL-C), according to a study published in the May 1 issue of the Journal of Clinical Endocrinology & Metabolism.

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Healthy Lifestyle Offsets Cardio Risks From Job Strain

TUESDAY, May 14 (HealthDay News) -- For individuals with job strain, a healthy lifestyle is associated with a reduced risk of coronary artery disease, according to a study published online May 13 in CMAJ, the journal of the Canadian Medical Association.

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No Change in Sodium Content of Ready Food From '05 to '11

MONDAY, May 13 (HealthDay News) -- From 2005 to 2011, there was no significant change in the sodium content of processed and fast-food restaurant foods; and on average, meals at sit-down restaurants (SDRs) contain more than a full day's worth of sodium, according to two studies published online May 13 in JAMA Internal Medicine.

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New FDA Survey to Assess Doc Attitudes on DTC Advertising

MONDAY, May 13 (HealthDay News) -- The U.S. Food and Drug Administration plans to conduct a new survey involving 2,000 health care professionals to examine their views on direct-to-consumer (DTC) advertising of prescription medications. The survey has been approved by the White House Office of Management and Budget.

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Even Mild Iodine Deficiency Can Affect Child's Cognition

MONDAY, May 13 (HealthDay News) -- Even mild iodine deficiency during pregnancy can have long-term adverse effects on a child's cognition, according to a study published in the May 1 issue of the Journal of Clinical Endocrinology & Metabolism.

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'Eating More Protein' Strategy Helps Women Lose Weight

FRIDAY, May 10 (HealthDay News) -- Women who report "eating more protein" as a weight loss strategy achieve weight loss over two years, according to a study published in the May issue of the Journal of Nutrition Education and Behavior.

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Poor Service, Bedside Manner Top Patients' Online Complaints

FRIDAY, May 10 (HealthDay News) -- On "rate-your-doctor" websites, patients complain more about poor bedside manner and unprofessional office staff than inadequate medical skills, according to a recent multi-city study published by Vanguard Communications.

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Hormones, Amino Acids Altered by Gastric Bypass Surgery

FRIDAY, May 10 (HealthDay News) -- Gastric bypass surgery alters the hormones and amino acids produced during digestion, possibly elucidating the mechanisms through which the surgery eliminates symptoms of type 2 diabetes, according to a study published in the May issue of the Journal of Clinical Endocrinology and Metabolism.

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Insurer Incentive Program for Obese Encourages Walking

FRIDAY, May 10 (HealthDay News) -- Most obese members of a health insurer participating in a pedometer-based financial incentive program met their step targets and appreciated the value of the program, according to a study published online May 8 in Translational Behavioral Medicine.

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User Satisfaction With Electronic Health Records Down

FRIDAY, May 10 (HealthDay News) -- Since 2010, there has been a decrease in the satisfaction and usability ratings for certified electronic health records (EHRs), according to survey results presented by the American College of Physicians (ACP) and AmericanEHR Partners.

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Title V Coverage Varies Across States for Diabetes

THURSDAY, May 9 (HealthDay News) -- There is significant state by state variation in Title V medical coverage for children with diabetes, according to a study published in the April issue of The Journal of Pediatrics.

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HHS Releases Data on Inpatient Charges for Hospital Services

THURSDAY, May 9 (HealthDay News) -- To promote transparency in the health care system, the first part of a three-part initiative has been released by the U.S. Department of Health and Human Services (HHS). The report provides consumers with information on hospital charges and highlights the considerable variation across the country for common inpatient services.

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Smartphones, Smartphone Apps Increasingly Used by Docs

THURSDAY, May 9 (HealthDay News) -- Smartphones and smartphone applications are increasingly being used in a professional capacity among physicians, according to two reports published in the March issue of Kantar Media Sources & Interactions Study-Medical/Surgical Edition.

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Cases Question Diagnostic Criteria for Inherited Diabetes

WEDNESDAY, May 8 (HealthDay News) -- Two patients diagnosed with a genetic form of non-insulin-dependent diabetes developed diabetic ketoacidosis years later, even though a history of diabetic ketoacidosis is normally an exclusion criterion for genetic testing, according to two case reports published online April 22 in Diabetes Care.

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Virtual Reality Beneficial for Weight Maintenance

WEDNESDAY, May 8 (HealthDay News) -- Virtual reality (VR)-based weight management may improve weight loss maintenance in overweight and obese adults, according to a study published in the May issue of the Journal of Nutrition Education and Behavior.

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Application for Health Coverage Has Been Simplified, Shortened

WEDNESDAY, May 8 (HealthDay News) -- The application for health insurance coverage has been simplified and shortened, with the application reduced to three pages for individuals, according to a report released April 30 by the Centers for Medicare & Medicaid Services (CMS).

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For Men, Obesity in Youth Ups Cardiometabolic Risk by Age 55

TUESDAY, May 7 (HealthDay News) -- Nearly half of young, obese men have an adverse cardiometabolic event or die before age 55 years, according to a study published online April 29 in BMJ Open.

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LAP-BAND Safe, Effective for Obese With BMI <40 kg/m²

TUESDAY, May 7 (HealthDay News) -- The LAP-BAND adjustable gastric banding system (LAGB) is safe and effective for obese individuals with a body mass index (BMI) of 30 to 39.9 kg/m², according to a study published online May 2 in Obesity.

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Genetic Variant May Explain Weight Loss Post-RYGB Surgery

TUESDAY, May 7 (HealthDay News) -- A genetic variant associated with weight loss after Roux-en-Y gastric bypass (RYGB) surgery has been identified, according to a study published in the May 2 issue of the American Journal of Human Genetics.

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Diabetes, Hypertension Prevalent With Spinal Stenosis

TUESDAY, May 7 (HealthDay News) -- Nonelderly, older adults with lumbar spinal stenosis (LSS) have a higher prevalence of diabetes and hypertension than those without stenosis, according to a study published in the April 20 issue of Spine.

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Injecting Insulin Through Clothes May Contribute to Infection

FRIDAY, May 3 (HealthDay News) -- Insulin injections have been associated with non-tuberculous mycobacteria cutaneous infections and cutaneous mycobacteria may have a prolonged incubation period, according to a literature review and case study published in the April issue of Clinical Diabetes.

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Patients Most Annoyed by Long Waits, Unclear Test Results

FRIDAY, May 3 (HealthDay News) -- Long waiting times and unclear test results are the top patient grievances when it comes to visiting the doctor, according to a report published in the June issue of Consumer Reports.

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CDC: About One in Five U.S. Adults Meets Exercise Guidelines

FRIDAY, May 3 (HealthDay News) -- In 2011, about 20 percent of U.S. adults met guidelines for both aerobic and muscle-strengthening physical activity, according to research published in the May 3 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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~13 Percent of Total Calories Come From Added Sugars

FRIDAY, May 3 (HealthDay News) -- For U.S., adults, about 13 percent of calories consumed are from added sugars, with the mean percentage decreasing as age and income increase, according to a May data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Medicaid Coverage Doesn't Lead to Better Physical Health

THURSDAY, May 2 (HealthDay News) -- Medicaid coverage does not seem to produce improvements in measured physical health outcomes within two years, but does have some effects, including increased use of health care services and reduced financial strain, according to research published in the May 2 issue of the New England Journal of Medicine.

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Health Industry Payment Details to Be Publicly Available

THURSDAY, May 2 (HealthDay News) -- As part of the National Physician Payment Transparency Program and in compliance with a provision in the Affordable Care Act (ACA), the government will make information about financial relationships between doctors, teaching hospitals, and drug and device manufacturers publicly available on a new Centers for Medicare and Medicaid Services website, according to a report published by Kaiser Health News.

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