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How Does the Potential for Weight Gain Influence Choice of Therapies?
Zachary T. Bloomgarden, MD, MACE: Weight gain is, of course, an important issue in diabetes. We know that diabetes occurs on a background of obesity in so many individuals. We know that the growth in obesity in the US population, and around the world, has tracked with the increase in the prevalence of diabetes. It’s unfortunate and upsetting that many of the drugs we use in treating diabetes actually are associated with weight gain—in particular, insulin, sulfonylureas, and thiazolidinediones.
So, as a first approximation, one would say we should try to avoid the use of these agents in people with diabetes whenever possible, recognizing that because diabetes is intrinsically a disease with reduced insulin secretory capacity, there are many individuals who simply will require insulin at some point in the natural history of their disease. Also, this new information from the IRIS (Insulin Resistance Intervention after Stroke) trial of pioglitazone recognizes that this may be an insulin sensitizer which reduces the possibility of stroke and myocardial infarction, and that could well outweigh any disadvantage of weight gain.
A new federal rule will enable thousands of immigrants in the Deferred Action for Childhood Arrivals (DACA) program to obtain health care through the Affordable Care Act; a forthcoming CMS rule is expected to lower home-based care wait times and raise caregiver wages; the HHS Office for Civil Rights has finalized 2 rules that strengthen the ACA’s health care discrimination ban.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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Initiating BP Medication Linked to Higher Fall, Fracture Risks in Nursing Home Residents
May 2nd 2024Among over 60,000 nursing home residents who initiated antihypertensive medication, rates of excess fractures due to falls per 100 person-years were as high as 5 among certain patient groups, such as those with dementia and high blood pressure (BP).
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