- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Complications of Diabetes and Role of Insulin Resistance in Metabolic Syndrome
Zachary T. Bloomgarden, MD, MACE: We somewhat arbitrarily have divided the complications of type 2 diabetes into 2 groups: microvascular—referring to small vessel abnormalities [such as] diabetic neuropathy, diabetic retinopathy, and diabetic nephropathy; and macrovascular—referring to atherosclerotic cardiovascular disease. These are the major complications of diabetes and affect a huge proportion of individuals with the disease.
We understand type 2 diabetes as representing the intersection of both genetically and environmentally determined patient characteristics. One is insulin resistance—decreased action of insulin at its receptor. That is caused by the environment, namely obesity, lack of physical activity, and a number of genetic factors, as well.
Then, [another characteristic is] reduction in the insulin secretory response to various stimuli, and this is probably primarily a genetic factor. So, in this context, the insulin secretory effect is not directly related to the other aspects of metabolic syndrome. But metabolic syndrome is essentially a constellation of abnormalities that are all related to insulin resistance. This is what seems to be the central actor that leads to hypertension, that leads to a certain form of dyslipidemia caused by obesity (particularly abdominal obesity), which then leads to the concurrence of diabetes with the other cardiovascular risk factors.
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.
Listen
Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
Listen
Dr Michael Farwell on FDG PET/CT Imaging to Predict Immunotherapy Response in Advanced Melanoma
April 15th 2024Michael Farwell, MD, associate professor of radiology at the Hospital of the University of Pennsylvania, provides insights into a study on the benefits of using 18F-fluorodeoxyglucose (FDG) PET/CT imaging to detect metabolic tumor changes in skin cancer.
Read More
