Diabetes

CMS' decision to pay primary care physicians to coordinate for seniors with multiple chronic conditions cannot soon enough, if a study in Clinical Diabetes is any sign.

The argument for cost-effectiveness has become important in the care of patients with diabetes and other comorbidities, as patients typically take multiple medications, each with its own cost-both to the payer and to the patient in the form of a co-pay-as well as some side effects.

A study published in JAMA Surgery compared long-term weight loss and other outcomes, along with adverse effects, of different surgical methods for weight loss.

The medication adherence problem is emblematic of the larger coordinated care issue in the US healthcare system, according to Trishan Panch, MBBS, MPH, chief medical officer at Wellframe.

Real-world studies of SGLT2 inhibitors show that this new class of drugs for type 2 diabetes has lowered A1C more than rivals. Patients lose more weight than with other oral therapies, and the benefit of controlling hypertension may make it possible for some patients to stop taking other drugs.

As accountable care organizations work to deliver population health, patient satisfaction, and cost savings, the need to engage patients as partners in their own healthcare has never been more essential. The ACO and Emerging Healthcare Delivery Coalition, an initiative of The American Journal of Managed Care, gathered this week at the historic Hotel del Coronado in San Diego, California, to explore ways to make patients the starting points of healthcare, not just its recipients.

California's policies to limit what kinds of foods and beverages can be sold alongside meals regulated by the National School Lunch Program are among the strictest in the nation. The rules appear to have helped stabilize and, in some areas, reverse childhood obesity trends.

Today's call for Medicare to cover the Diabetes Prevention Program is part of a broader effort by advocacy groups and the AMA to identify those with prediabetes and intervene before people develop full-blown diabetes.

The study, called the the SLIMM-T2D (Surgery or Lifestyle with Intensive Medical Management in Treatment of Type 2 Diabetes) trial, was published in the Journal of Clinical Endocrinology & Metabolism and observed similar improvements in blood sugar control a year after gastric band surgery or being on a group-based weight management program.

Studies have shown that embedding behavioral health services into the primary care practice produces better health outcomes for patients with diabetes, while reducing indications of depression. The challenge is figuring out how to make the transition to new payment models that reward such care.

A review of 24 trials covering more than 10,000 patients confirmed earlier findings that PCSK9 inhibitors dramatically reduce cholesterol and risk of heart attacks. But an editorial that appeared alongside the meta-analysis in Annals of Internal Medicine said long-term studies are needed on this new drug class.

CMS wasted nearly $251 million in taxpayer dollars on infusion drugs in just 18 months by using outdated drug pricing estimates, which drove up the cost of prescription injectable drugs for an aging baby boomer population.

Vivek Murthy, MD, MBA, who took office as US Surgeon General in December and has a ceremonial swearing-in Thursday, says he hopes to reduce chronic diseases such as obesity, diabetes, and heart disease by promoting physical activity.

The diabetes drug metformin is being used in some cancer treatment trials, but study results show the use of metformin does not improve survival of patients with pancreatic ductal adenocarcinoma.

In its third year, Patient-Centered Diabetes Care, which took place April 16-17, 2015, in Boston, showed how new payment models, new therapies, and new approaches to patient engagement are changing care for persons with diabetes. The American Journal of Managed Care and Joslin Diabetes Center presented this year's meeting.

Having people from different parts of the diabetes care equation talking together at the 3rd Annual Patient-Centered Diabetes Care Meeting is what will move the industry forward, according to Robert A. Gabbay, MD, PhD, chief medical officer and senior vice president at Joslin Diabetes Center and the editor-in-chief of Evidence-Based Diabetes Management journal.

Recent emphasis of identifying those with prediabetes and intervening to halt its progression is aimed at reducing the financial impact of diabetes in the United States, which was estimated in 2012 at $245 billion.

There were no significant differences in the risk of ambulatory care—sensitive condition hospitalization or mortality between patients who initiated analogue insulin compared with the neutral protamine Hagedorn.

Smartphone data is now being used for crowdsourcing studies of diabetes, asthma, cardiovascular disease.

Currently partnered with Apple, Johnson & Johnson, and Medtronic, IBM is also buying Explorys and Phytel, 2 start-ups that can boost IBM's presence in the healthcare world.

Onglyza (saxagliptin), developed by AstraZeneca, was found to cause an increased risk of heart failure.

Incentives in employee wellness programs, especially penalties, can hurt morale and lead to legal action. But without incentives, there's no guarantee the employer will see healthcare savings and return on investment.

Hospitals like Boston Children's and Penn Medicine think they are better off building in-house apps that are custom-made for their workflow, rather than risk buying those available in the market, which may not necessarily be a perfect fit.

Researchers worked with nearly 3800 individuals to establish workplace programs that focused on healthy eating and increasing physical activity. At the end of the study period, the number of employees in the control site who were overweight/obese increased by about 5%, while the number in the intervention group had decreased by 4%, resulting in a net difference of 9%.

Quality benefits were equal across racial/ethnic groups with equal personal health record (PHR) use, but nonwhite status and a preference for Spanish language predicted lower PHR registration.