Posted by Staff
Minority Diabetes Reports
Thursday, June 28th, 2012
A researcher says an organization’s leadership plays a key role in ensuring that everyone receives equal care.
By CAROLYNE KRUPA, amednews staff. Posted June 18, 2012.
Public and private entities nationwide are tackling the complex challenge of reducing health disparities among racial and ethnic minorities, but many national physician associations and societies have little or no programs to address them.
A study of 167 such organizations found that 32% have no programs that target health disparities, and 21% have just one activity. The study did not list the specific groups included in the research, but said that most organizations evaluated had 1,000 or more members. Those most likely to have disparities-related efforts include primary care and minority physician organizations and those that have formed committees to address the issue, says a study in the June issue ofAcademic Medicine.
“The data suggest that although physician organizations are well positioned to work toward the reduction of disparities, they could be doing much more,” American Medical Association Executive Vice President and CEO James L. Madara, MD, wrote in an accompanying commentary. Read More
Posted by Staff
Minority Diabetes Reports
Thursday, June 28th, 2012
Endocrinetoday.com: Posted on June 12, 2012.
PHILADELPHIA — Use of a Spanish-language, tablet computer-based communication tool resulted in a higher rate of discussion of CVD risk and changes in medications to treat risk factors in a group of Hispanic adults with type 2 diabetes.
Paris Roach, MD, reported data from a randomized controlled comparison of the intervention, as compared with usual care, at four urban primary care clinics providing care to the local Spanish-speaking Hispanic population.
“The goal was to get patients more involved in their own care so they can understand their risk [for CVD], be activated to discuss risk with their primary care providers, and adopt and adhere to therapies to address their risk factors,” Roach, associate professor of clinical medicine, division of endocrinology, Indiana University School of Medicine, said during an oral session at the American Diabetes Association’s 72nd Scientific Sessions.
The multimedia communication tool consists of a series of 5- to 12-minute video presentations that patients viewed on tablet computers just prior to outpatient visits. Each presentation incorporates individual CVD risk factor data and 10-year CVD risk based on UKPDS Risk Engine Estimates. The tool provides patients with an overview of CVD risk using the patient’s own clinical data, calculates risk and displays risk factors, according to Roach.
The efficacy of the communication tool was studied in 122 Spanish-speaking patients with type 2 diabetes and no known CVD (mean age, 47 years). Each patient had at least one uncontrolled CVD risk factor (LDL ≥130 mg/dL; systolic BP ≥150 mm Hg; HbA1c ≥8%). Patients were assigned to the intervention group or a control group. Read more
Posted by Staff
Minority Diabetes Reports
Thursday, June 28th, 2012
Care.diabetesjournals.org: May 17, 2012.
OBJECTIVE Elevated plasma interleukin-18 (IL-18) has been linked to onset of diabetes mellitus (DM) and its complications. However, so far this association has been shown only in predominantly white populations. We examined IL-18 levels and their association with incident DM in a racially heterogeneous population.
RESEARCH DESIGN AND METHODS In a nested case-cohort design representing a 9-year follow-up of 9,740 middle-aged, initially healthy, nondiabetic white and African American participants of the Atherosclerosis Risk in Communities Study, we selected and measured analytes on race-stratified (50% white, 50% African American) random samples of both cases of incident diabetes (n = 548) and eligible members of the full cohort (n = 536). Read more
Posted by Staff
Clinical Trials
Thursday, June 28th, 2012
Centrally Obese Hypertensive Individuals With Diabetes The Action to Control Cardiovascular Risk in Diabetes (ACCORD) Blood Pressure Trial
Care.diabetesjournals.org: July 2012.
OBJECTIVE The Action to Control Cardiovascular Risk in Diabetes (ACCORD) Blood Pressure Trial reported no differences in most cardiovascular disease (CVD) outcomes between intensive and standard blood pressure therapy in individuals with diabetes mellitus (DM) and hypertension. Many such individuals are centrally obese. Here we evaluate whether the trial outcomes varied by the level of central obesity.
RESEARCH DESIGN AND METHODS The cohort included 4,687 people (47.7% women) with DM and hypertension. Mean age was 62.2, and mean follow-up was 4.7 years. Participants were randomly assigned to one of two blood pressure treatment strategies: intensive (systolic <120 mmHg) or standard (systolic <140 mmHg). Sex-specific quartiles of waist-to-height ratio were used as the measure of central obesity. The primary ACCORD outcome (a composite of nonfatal myocardial infarction [MI], nonfatal stroke, or CVD death) and three secondary outcomes (nonfatal MI, fatal or nonfatal stroke, and CVD death) were examined using proportional hazard models. Read More
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News
Thursday, June 28th, 2012
Care.diabetesjournals.org: July 2012.
OBJECTIVE To assess β-cell function preservation after 3.5 years of intensive therapy with insulin plus metformin (INS group) versus triple oral therapy (TOT group) with metformin, glyburide, and pioglitazone.
RESEARCH DESIGN AND METHODS This was a randomized trial of 58 patients with treatment-naïve newly diagnosed type 2 diabetes. All patients were treated with insulin and metformin for a 3-month lead-in period followed by random assignment to the INS or TOT group. β-Cell function was assessed using a mixed-meal challenge test at randomization and 6, 12, 18, 30, and 42 months. Analyses were intention to treat and performed with repeated-measures models. Read More
Posted by Staff
Clinical Trials
Thursday, June 28th, 2012
Care.diabetesjournals.org: July 2012.
OBJECTIVE To evaluate the effects of qualitative dietary changes and the interaction with aerobic exercise training on liver fat content independent of weight loss in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS With use of a factorial 2 × 2 randomized parallel-group design, 37 men and 8 women, aged 35–70 years, with type 2 diabetes in satisfactory blood glucose control on diet or diet plus metformin treatment were assigned to one of the following groups for an 8-week period: 1) high-carbohydrate/high-fiber/low–glycemic index diet (CHO/fiber group), 2) high-MUFA diet (MUFA group), 3) high-carbohydrate/high-fiber/low–glycemic index diet plus physical activity program (CHO/fiber+Ex group), and 4) high-MUFA diet plus physical activity program (MUFA+Ex group). Before and after intervention, hepatic fat content was measured by 1H NMR. Read more
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News
Thursday, June 28th, 2012
News-medical.net: Published on June 25, 2012 at 11:25 AM
Many patients with type 2 diabetes may be aspirin resistant. That means the standard aspirin dose may not protect them against blood clots that cause heart attacks andstrokes among diabetics, a new clinical study finds. The results will be presented Sunday at The Endocrine Society’s 94th Annual Meeting in Houston.
“This result adds to our understanding of the prevalence of this problem, which varies considerably among studies,” said lead author Subhashini Yaturu, M.D., section chief of the Endocrinology and Metabolism Department at Stratton VA Medical Center in Albany, NY. “The standard baby aspirin may not be adequate for subjects with diabetes for cardiovascular protection.”
Low doses of aspirin are recommended for the prevention of strokes and heart attacks. Aspirin is considered the usual treatment to prevent dangerous blood clots from forming. It is recommended for patients with diabetes and other high-risk medical conditions. In some cases, however, patients are resistant to aspirin’s anti-clotting effects. This resistance can be identified by measuring the level of a particular chemical called 11-dehydro-thromboxane beta-2, or 11DhTx2, which is formed during the clotting process. High urinary levels of this chemical indicate resistance to aspirin and its beneficial anti-clotting effects. Read more
