Diabetes

The study highlights the complexity of prescribing medication for those with type 2 diabetes.

This week in managed care included takeaways from the annual meeting of AMCP, the Supreme Court hears arguments regarding drug patent review, and CMS updates Medicaid managed care rules.

Unlike its closest rival, CVS Health, Express Scripts does not have a retail healthcare delivery infrastructure.

Two years after CDC heralded a drop in obesity rates among the youngest children, authors of a new study say it's too soon to declare victory.

The study team previously published research that linked diabetes to elevated rates of certain cancers.

The FDA issued a warning on the SGLT2 inhibitor class in May 2015, but the review by AACE and ACE found that several of the cases involved patients with type 1 disease.

A diabetes drug may have benefits for people with chronic heart failure. Boehringer Ingelheim and Eli Lilly and Company have announced plans to investigate the use of the diabetes medicine Jardiance for heart failure with 2 outcome trials.

The study showed the need to test children with type 1 disease for a lack of vitamin D.

Hospital readmissions are a key quality indicator, and reducing those means learning which at-risk patients return for care. A study in The American Journal of Managed Care examined children with type 1 diabetes enrolled in Managed and Traditional Medicaid programs across 25 states, who are more likely to have incidents of diabetic ketoacidosis, a costly cause of readmission.

Since the study period ended, new results show a long-term cardioprotective benefit for empagliflozin and liraglutide.

An analysis of the largest cohort available reveals that youths with type 1 diabetes, on a Medicaid managed care plan, are less likely to be readmitted within 90 days of discharge.

The health groups' letter comes after CSPI's February report, Carbonating the World, which spelled out global investment by Coca-Cola and PepsiCo.

The results, published in Diabetes Care, move the hope of pancreatic cell islet transplants close to commercialization, which would bring the technique to more patients who cannot produce their own insulin.

Data on drug prescriptions, diagnoses, and events are increasingly being used for epidemiologic and pharmacologic studies and for the evaluation of quality of care, but questions arise about how complete and accurate the diagnoses and events in these databases are.

The top stories in managed care include a recap of Patient-Centered Diabetes Care, the case for the Oncology Medical Home, UnitedHealth leaves Affordable Care Act exchanges in 2 states, and CMS expands alternative payment model for primary care.

From the focus on prevention to the possibilities of telehealth, the annual meeting presented by The American Journal of Managed Care and Joslin Diabetes Center showed where care is heading.

The authors say increased attention to gut and adipose hormones will reveal pathways to treat infertility.

The study, funded by Medtronic, follows an earlier study that compared pump users to those using daily injections to manage type 2 diabetes.

FDA classifies this as a Class I recall, which means using the device could result in adverse health effects or death.

Concern about overnight hypoglycemic events drives decision-making for patients with type 1 diabetes.

With the news that Medicare will soon pay for diabetes prevention, the 2016 edition of Patient-Centered Diabetes Care, presented by The American Journal of Managed Care, offered up-to-the-minute news on how technology will change the prevention and clinical care models, why ending stigma is key to treating obesity, and what’s ahead in insulin therapy.

Patient-Centered Diabetes Care (PCDC) is important because it provides a venue to share new knowledge and to meet different stakeholders that impact diabetes care, explained Robert A. Gabbay, MD, PhD, FACP, chief medical officer of the Joslin Diabetes Center, chair of PCDC, and editor-in-chief of Evidence-Based Diabetes Management.

While payer coverage for obesity care has improved since the American Medical Association declared that obesity is a disease, there's still a long way to go. Physician training must improve to eliminate stigma that keeps patients from getting care they need, according to experts who appeared at Patient-Centered Diabetes Care.

CMS' plan to pay for the National Diabetes Prevention Program is an important step toward payer coverage of technology-based diabetes care. But reimbursement for telehealth to treat type 2 diabetes remains challenging.

Diabetes care is incredibly complex and people are still trying to use data to predict issues with glycemic control, determine what the best combinations of drugs are, and to improve adherence with patients, explained Lonny Reisman, MD, CEO of HealthReveal and keynote speaker at Patient-Centered Diabetes Care.

It takes a village to manage people with diabetes, and that includes involving other professionals like diabetes educators, dieticians, and pharmacists more effectively, said Robert A. Gabbay, MD, PhD, FACP, chief medical officer of the Joslin Diabetes Center, chair of Patient-Centered Diabetes Care, and editor-in-chief of Evidence-Based Diabetes Management.

There may be some reluctance to reimburse telemedicine because there is a feeling that telemedicine costs might be added to overall cost, rather than be substituted, David Brumley, MD, MBA, senior medical director at Tufts Health Plan, explained at the 4th Annual Patient-Centered Diabetes Care Meeting, held April 7-8 in Teaneck, NJ.

Growth in retail health clinics reveals unmet medical needs for Americans who lack insurance, who cannot leave work, or who have disconnected with the health system. This growing sector of the health system is diagnosing and treating diabetes cases that would otherwise be missed.

Lonny Reisman, MD, CEO of HealthReveal, told attendees at Patient-Centered Diabetes Care that harnessing multiple disparate data sources can help physicians deliver better solutions at the point of care.

With not enough endocrinologists to go around, primary care physicians are important when it comes to caring for patients with diabetes, Albert Tzeel, MD, MHSA, FAAPL, regional medical director, senior products, Humana, said at the 4th Annual Patient-Centered Diabetes Care Meeting, held April 7-8, in Teaneck, NJ.