Diabetes

The move means the nation's largest payer will invest in diabetes prevention, which has been a focus of CDC, the American Medical Association, and the American Diabetes Association.

An estimated 29.1 million Americans have diabetes; most have type 2 disease. While the CDC reported in December that new cases had fallen for the first time in a generation, there are disparities in who gets the disease. It hits harder among the poor and minorities.

The study from researchers at Cleveland Clinic found that during the years before full implementation of the Affordable Care Act, a shift in treatment methods for patients with a painful condition was associated with fewer amputations and deaths. But large disparities remain.

This week, the top managed care stories include Humana announcing executive bonuses are now partially tied to value, Veterans Affairs has expanded access of hepatitis C drugs to all veterans in the system, and CDC releases guidelines on prescribing opioids.

In Soda Politics, Marion Nestle, PhD, traces the history of the giant soda companies in the United States, and how they have copied the tactics of Big Tobacco to get children "drinking sugar," with resulting rates of diabetes and obesity. Other groups are joining Nestle in criticizing the export of heavy soda marketing to the developing world.

The availability of a novel predictive biomarker in diabetes care could have benefits for patients, payers, and pharma.

Medication therapy management is a key component of ensuring good outcomes in diabetes care. The clinical pharmacist can play a key role in ensuring good transitions of care, avoiding problems of polypharmacy, addressing financial issues, and providing patient education.

Dr Gabbay is editor in chief of Evidence-Based Diabetes Management.

There has been interest in learning whether the SGLT2 inhibitor class could benefit those with type 1 diabetes who have been unable to achieve good glycemic control on insulin alone. The thought is that this class could help smooth out daily peaks and valleys in blood glucose levels.

A case management program implemented by Coventry Healthcare in one of the nation's poorest areas produced positive, measurable results among patients with diabetes.

The research puts data behind long-simmering complaints from patients and clinicians about availability of diabetes test strips.

Regeneron and Sanofi vowed to appeal the ruling; analysts said that process could take at least a year. While Amgen has asked for a permanent injunction, some see payment of royalties to Amgen as a more likely outcome if Regeneron is ultimately not successful.

Researchers found patients taking canagliflozin had more improvement in A1C levels than those taking DPP-4 inhibitors, and those taking canagliflozin were more likely to achieve key thresholds recognized by Medicare and other payers.

Authors from the Mayo Clinic discuss situational goals in diabetes care, because quality targets enforced too strictly may harm patients who are working hard to manage their disease.

Authors from the National Quality Forum discuss development of the next generation of diabetes measures, including those that reflect "the voice of the patient."

An introduction to the Joslin Clinical Analytic Tool, a new diabetes measure developed to adjust for the variety in patient mix and better inform clinicians which interventions will work best.

On Tuesday, March 22, 1-2 pm ET, The American Journal of Managed Care will host a tweetchat with Joslin Diabetes Center to discuss diabetes management and the current status of diabetes performance measures.

Michael Castagna, PharmD, MBA, has significant sales and marketing experience, but does he have enough time or money to rescue Afrezza?

Did MannKind misjudge consumer demand, or are barriers from payers to blame for Afrezza's woes? A feature outlining the misfortunes and future plans for the only inhaled insulin on the market.

Both the authors and the writer of an editorial said obese women should be warned of potential risks, but that with absolute stroke risk low, they should not be denied access to contraception.

The top stories in managed care this week included a proposed new payment model for Medicare Part B and the swift criticism that followed the announcement, findings on variation in cost based on site of care, and cardiovascular results for Victoza.

The proposals recommend modernizing policies across the healthcare industry, including the drug discovery and development process, promoting value-driven healthcare, increasing the consumer voice, and addressing market distortions.

Improved health technologies will help physicians better monitor patients with chronic conditions so that those patients can receive more effective care and will help build a bridge between what has been reported as effective in literature and applying it to the patient, explained Lonny Reisman, MD, founder and CEO of HealthReveal.

Integrated approaches using electronic health records, clinical decision support, and patient-controlled technologies may help improve the appropriate use of medication as well as the management of type 2 diabetes.

The study revealed large disparities in prediabetes levels among young adults by race and ethnicity, underscoring the challenge for public officials in finding solutions to poor access to healthy food and safe places for children to play.

With the movement toward rewarding doctors based on how well they deliver care comes the question: how to adjust for the different patients doctors see? Authors writing in The American Journal of Managed Care reviewed 13 different studies and made a startling finding-most factors we assume merit adjustments in diabetes care do not, based on evidence thus far.

The study found that being out of shape aerobically and having poor muscle strength made a young man 3 times more likely to develop diabetes as he got older.