Diabetes

This week, the top stories in managed care included the president's pick to lead the FDA testified before a Senate committee; Mylan recalls EpiPen batches and faces a class action lawsuit; and a study ties being a night owl to increased depression in patients with diabetes.

Research presented this week at the 99th annual meeting of the Endocrine Society suggested that people with type 2 diabetes who worked overnight shifts tend to have poorer control over their blood sugar levels than those who worked during the day or were unemployed.

New payment models in Medicare and beyond recognize the connection between mental health and conditions like diabetes and obesity.

The new study shows that looking at a person's body mass index over an extended period gives a fuller picture of the relationship between excess weight and mortality.

More studies are recognizing the role of sleep in overall health, along with diet and exercise.

Children need support from their families to fight obesity, as they lack the tools to change their diet and exercise patterns alone, according to Fatima Cody Stanford, MD, MPH, MPA, FAAP, FTOS, of Harvard Medical School and Massachusetts General Hospital. Getting obesity under control in childhood is key to reducing the risk of negative health outcomes later in life.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

With new technologies that allow insulin to be delivered much more easily and at a targeted speed, diabetes treatment is less likely to interfere with patients’ lives, explained Yehuda Handelsman, MD, FACP, FACE, FNLA, medical director and principal investigator at the Metabolic Institute of America.

This week, the top managed care news included new radiology guidelines for early-stage breast cancer; 4 continuing healthcare challenges for President Donald Trump; and Medicare coverage for Dexcom's continuous glucose monitor.

A new study published in Annals of Internal Medicine has observed encouraging results from a program that implemented a virtual glucose management system for hospital inpatients.

While rare, diabetic ketoacidosis occurs overwhelmingly in patients taking SGLT2 inhibitors with type 2 diabetes, according to the analysis from 3 North Carolina medical schools.

Liz Zhou, MD, director of evidence-based medicine at Sanofi Medical Affairs outlined the purpose of a study on real-world results of comparing basal insulin dose changes in type 2 diabetes patients using Lantus who either stay on Lantus or switch to Toujeo.

Dexcom's G5 Mobile is the only continuous glucose monitoring system that meets Medicare criteria for coverage. However, details of the coverage rules released this week state that people with diabetes who want coverage cannot use the system with a smartphone app.

Other studies have examined the link between snoring and diabetes. The lack of oxygen in snoring leads to increased insulin resistance, researchers believe.

The results are consistent with prior surveys by the American Association of Diabetes Educators. The group said CMS has put its 2019 round of bidding on hold, a move it "applauds."

The review found that only a fraction of the syndromes had been fully studied, and no gene or chromosomal location has been found for more than a quarter of them.

This week, the top stories in managed care included last-minute changes to Republicans' bill to repeal the Affordable Care Act; a lack of votes to pass the GOP health bill; and promising study results on PCSK9 inhibitors and SGLT2 inhibitors.

The study identified a target that reacts to the implantation of biomedical materials. The findings could to improvements in insulin pump infusion sets and CGM sensors.

The initiative includes targeted efforts in 7 cities to reduce the number of "unhealthy days," a metric devised by CDC to gauge physical and mental well-being.

The pilot project enrolled children who had a parent simultaneously taking the Diabetes Prevention Program, which has been shown to reduce progression to type 2 diabetes by 59%.

The studies will be done in patients with and without type 2 diabetes.

The analysis followed a landmark study in 2015 that showed insulin sensitivity could improve in patients with type 2 diabetes after only 10 days in a colder climate.

The CVD-REAL study presented at the American College of Cardiology 66th Scientific Session asked whether cardiovascular outcomes seen in the EMPA-REG OUTCOME trial could be seen in a real-world environment, and for the entire class of SGLT2 inhibitors, according to AstraZeneca’s Jim McDermott, PhD, vice president for Medical Affairs, Diabetes.

The step comes after months of criticism about high insulin prices.

Results from the CVD-REAL study seek to answer questions raised by the EMPA-REG OUTCOME study: do the effects of SGLT2 inhibitors on heart failure apply to a broad population?

The study found a "dose effect" in the elderly women who took statins to treat cholesterol.

Home health beneficiaries with diabetes using paid supplementary caregivers had 68% higher hazards of readmission due to urinary tract infection than those with unpaid supplementary caregivers.

Coverage from the American College of Cardiology 2017 Scientific Session.

The study seeks to answer several questions that look at which patients benefit from surgery over the long term.

An insurance company—sponsored enhanced primary care program had little effect on selected outcomes for low-income patients with diabetes.