Diabetes

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A new Kentucky state law that expands prescribing authority for advanced practice registered nurses took effect Tuesday, the same day that a study was published touting the benefits of having nurses manage care for patients with chronic conditions such as diabetes and high blood pressure.

People with type 1 or 2 diabetes now have a new means of getting their medication, with the U.S. Food and Drug Administration's approval on Friday of the first inhaled medicine for the blood sugar disease.

Geisinger Health System's use of a diabetes care system among high-risk patients produced lower risks of myocardial infarction, stroke and retinopathy over a three-year period, according to a study in The American Journal of Managed Care. Best of all, most of the benefit accrued in the first year of care.

Most illnesses today are measured in terms of their effects on daily activities, but who do not always consider the outcomes based on the patient's perspectives. Many clinical studies instead apply standardized measures that identify quality of life as an important outcome. Advancing research methodologies, including new approaches to clinical research, should inform this discussion by centering medical decision making on the preferences of the most important stakeholder-the patient.

Studies presented at the American Diabetes Association's meeting in San Francisco took a deeper look at what the presence of fat does to overweight children. Researchers found that signs of trouble emerge early, with implications for the treatment of youths with type 1 diabetes, and those at risk of developing type 2 diabetes.

A symposium on the new drug class, SGLT2 inhibitors, drew plenty of interest from attendees at the American Diabetes Association meeting in San Francisco. SGLT2 inhibitors have gained notice, both for their ability to reduce A1C levels and for their potential to help patients lose weight.

A symposium that focused on the relationship between behavioral health and diabetes examined how the challenges of living with the disease wear on patients over time, ahead of results presented Sunday showing that much of what is diagnosed as "depression" in diabetes may not be. Presenters offered 3 models for better coordination of care.

A diabetes patient navigator program in Birmingham, Alabama, a joint project of the American Academy of Family Physicians Foundation and Sanofi US, resulted in lower A1C levels for its participants. Patients also reported higher levels of satisfaction in managing their disease.

For years, the standard for treating type 2 diabetes mellitus (T2DM) has been step therapy. Patients are told to make changes in their diets and to exercise more. Then, most start metformin; if T2DM progresses, doctors add drugs from among the dozen other classes, either alone but typically in combination.

Teresa Pearson, MS, RN, CDE, Innovative Health Care Designs, LLC, uses her experience as a diabetes educator to discuss how community care teams can build an effective virtual healthcare delivery system.

Jan Berger, MD, MJ, moderates a discussion on the evolution of the diabetes care team. She is joined by Starlin Haydon-Greatting, MS, BSPharm, FAPhA , Geoffrey Joyce, PhD, Edmund Pezalla, MD, MPH, and Rebecca Killion, MA.

This panel, led by moderator Dennis Scanlon, PhD, Penn State University, asks the question, "Why should a payer or a plan be involved in patient care?" Dr Scanlon is joined by panelists Teresa Pearson, MS, RN, CDE, FAADE; Deneen Vojta, MD; Todd Prewitt, MD, FAAFP; and Amy Tenderich.

Starlin Haydon-Greatting, MS, BSPharm, claims that pharmacist education has changed; by furthering education and credentials, a pharmacist's role in the healthcare world can extend far beyond what were once thought to be the traditional roles of the pharmacist. Pharmacists' involvement in programs such as the Medication Therapy Management, for example, can have a positive impact on health management in general.

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