Diabetes

For some patients newly diagnosed with type 2 diabetes, skipping metformin monotherapy and going straight to fixed-dose combinations with a DPP-4 inhibitor or an SGLT2 inhibitor makes sense, evidence shows.

Given the growing prevalence of type 2 diabetes (T2D) and its contribution to cardiovascular disease, cardiovascular outcomes trials should aim to be more representative of the average patient with T2D.

While obesity is a known risk factor in gestational diabetes, women who were obese and also were depressed when they became pregnant were at greater risk of gestational diabetes than those who did not have depression.

Evidence has been accumulating that links irregular sleep with chronic disease, but today is the first time the American Heart Association has issued a statement on the topic.

Officials say the company will file with FDA some time in the third quarter of 2016 to begin the approval process for the novel delivery system that brings a continuous, microscopic dose of exenatide to patients with type 2 diabetes.

Results for Novo Nordisk’s semaglutide were reported today at the European Association for the Study of Diabetes. A filing for FDA approval is expected before the end of the year.

The report showed a strong connection between states with high rates of inactivity and those with the highest rates of obesity.

The current issue of Evidence-Based Diabetes Management explores studies and patient access issues surrounding this closely watched inhaled insulin.

Gaining access to Afrezza can mean battling with an insurer to cover it. Sometimes the first hurdle is getting a doctor to write a prescription, according to those who've been through the process.

Professor R. Keith Campbell, MBA, BPharm, CDE, now retired from Washington State University College of Pharmacy, highlights the clinical advantages of Afrezza based on the evidence as well as his personal perspective.

The suit doesn't address whether soda taxes have any effect on obesity or public health, but instead hinges on finer points of Pennsylvania tax law and its constitution.

Pfizer and Merck plan to file new drug applications with FDA for the SGLT2 inhibitor by the end of the year. One combination would pair ertugliflozin with Januvia, the blockbuster DPP-4 inhibitor.

The authors said this is the first study to examine antihypertension nonadherence down to the county level. Recommendations include greater use of combination therapy to reduce pill counts for patients with multiple chronic conditions, and synchronizing pharmacy visits to avoid multiple trips.

While the report found that the obesity rate among service members had gone up steadily since 2001, it was still only a fraction of the rate among the US population overall.

The trial showed use of the flash glucose monitoring system dramatically reduced the number of finger sticks while significantly reducing hypoglycemia, including at night.

What we're reading, September 12, 2016: Hillary Clinton's health is being called into question as her campaign confirms she has pneumonia; responders who helped during the 9/11 terrorist attacks may be sick and not know it; and Sanofi and Google team up for a diabetes venture.

Scott Breidbart, MD, MBA, chief clinical officer of EmblemHealth, explained that paying patients for adherence could be efficient when the payment initiatives are targeted towards members who have not shown to be adherent; however, he added that there are several limitations in paying for adherence, including the sustainability of the system and whether it will incentivize patients who are adherent to stop taking their medications.

This week, the top stories in managed care were poll results that show Hillary Clinton is more trusted than Donald Trump when it comes to healthcare, multiple studies highlighting remaining disparities in healthcare, and results of a digital diabetes self-management program.

Millennials are one of the few bright spots in American well-being. According to Gallup, millennials in the United States have a lower obesity rate compared with older generations, and millennials have actually seen their obesity rate go down since 2008.

A group of patients receiving intensive diabetes management treatment lived 7.9 years longer and had fewer cardiovascular events, the study found.

The study supports earlier findings that warning labels affect parental choices of beverages for their children.

The study is the first to show a protective benefit of having a vaginal delivery after a prior cesarean birth.

Pediatricians are advised to not simply focus on weight loss, but also to examine behaviors. Too rapid weight loss could be a sign of trouble and dieting in young teens often leads to being overweight later.

Ted Kyle, RPh, MBA, principal at ConscienHealth, explained that in order to prevent diabetes, a patient’s health-related risks needs to be addressed, and part of these risks stem from obesity. He added that a program like Medicare’s diabetes prevention program is exactly the tool the curb this progression.

This week in managed care, the top stories included proposals from CMS to shore up the Affordable Care Act's marketplaces, research that highlighted the link between duration of obesity and cancer risk for women, and the results of an FDA diabetes workshop.

The state-by-state obesity figures revealed huge health disparities. Obesity rates for whites reached 35% in just 2 states, while the rates reached 35% for blacks in 34 states and the District of Columbia, and 11 states for Hispanics.

A diverse group of 1242 patients received diabetes self-management education either in-person or online and achieved lowered blood glucose and depression levels, had fewer symptoms of hypoglycemia, and exercised more.

Democratic lawmakers who signed a letter to Mylan this week say that the practice of offering coupons masks the high drug prices that are paid by commercial health plans. The practice is not allowed in Medicare or Medicaid.

A nationwide telemedicine diabetic screening program could help prevent diabetic retinopathy, the top cause of new-onset blindness in the United States.