Diabetes

Medicare beneficiaries with diabetes who are at the lowest levels of healthcare consumption often become some of the highest level consumers in subsequent years.

Ronald J. Sigal, MD, MPH, a professor of medicine, cardiac sciences, kinesiology, and community health sciences at the University of Calgary in Canada, and a Health Senior Scholar at the Alberta Heritage Foundation for Medical Research, pulls from his experience to discuss the reality of the current expectations and goals for exercise and physical activity in the overweight or obese patient with diabetes, and offers his solutions.

Philip R. Schauer, MD, the director of the Bariatric and Metabolic Institute (BMI) at the Cleveland Clinic in Ohio contends that accountable care organizations (ACOs) need to recognize obesity as a legitimate disease that is the basis for many other serious conditions. He emphasizes that obesity certainly requires treatment, and surgery is an appropriate intervention for certain patients.

Carl Dean Benton, RPh, explains how pharmacists can contribute to improvements in patient care through counseling programs. With the provisions of the Affordable Care Act, many insurers may begin to recognize the benefits of pharmacist-driven counseling initiatives, and integrate these programs to help improve outcomes for patients with type 2 diabetes.

Todd Brusko, PhD, of the Todd M. Brusko Laboratory at the University of Florida College of Medicine, discussed how knowledge of regulatory T-cells has grown and improved, and noted that research has now entered a phase of harnessing the potential of our immune system through specific cell populations to combat root causes of type 1 diabetes (T1DM).

Bernard Zinman, MD, the director of the Leadership Sinai Centre for Diabetes and the Sam and Judy Pencer Family Chair in Diabetes Research at Mount Sinai Hospital and the University of Toronto in Canada, discusses the new therapies, SGLT-2 inhibitors, that are now approved in the United States and European Union. These drug therapies have shown clinical benefits in both type 1 and type 2 diabetes, and may also improve cardiovascular outcomes for patients with type 2 diabetes

Jaakko Tuomilehto, MD, PhD, a professor of public health at the University of Helsinki in Finland provides global epidemiological data for T1DM and discusses the World Health Organization's Diabetes Mondiale (DiaMond) study. He compares the rates of incidences of T1DM among well-developed, high-income countries to low- and middle-income nations and takes note of the epidemiological trends.

In light of ongoing healthcare reform in the US, Sheldon Greenfield, MD, the executive co-director of the Health Policy Research Institute and Donald Bren Professor of Medicine at the University of California Irvine School of Medicine, shared his insights on the role of quality care measures in the management of diabetes, and weighed in on the advantages and disadvantages associated with implementing these tools.

Accounting for what is known about the association between diabetes and low testosterone in men, Rita Basu, MD, a professor of medicine at the Mayo Clinic in Rochester, MN provides her insights on the role of testosterone supplementation in men with diabetes, and notes how clinical and managed care perspectives are integrated in practice.

Cost-effectiveness analyses (CEAs) have real effects on therapeutic approaches for patients with type 2 diabetes mellitus (T2DM). Dr. Gilmer discusses how studies like the United Kingdom Prospective Diabetes Study (UKPDS) and the Diabetes Prevention Program (DPP) have affected how researchers and scientists evaluate the benefits of new treatments.

Sandeep Dhindsa, MD, an associate professor of medicine at the University of Buffalo School of Medicine and Biomedical Sciences discusses the relationship between diabetes and low testosterone in men, and also notes the significance of accounting for BMI and obesity.

Dr Andrew J. Palmer describes the costs of type 2 diabetes (T2DM) in the United States and worldwide. He also explains the importance of choosing treatments that are cost-effective and cost-saving for patients.

Jaakko Tuomilehto, MD, PhD, a professor of public het the University of Helsinki in Finland explains the association between a country's socioeconomic status and its epidemiology of type 1 diabetes (T1DM), shedding light on the various circumstances and factors that may contribute to the differences we see among other nations.

This study describes reasons for nonparticipation in type 2 diabetes mellitus education and identifies typical subgroups of nonparticipants in order to improve recruitment strategies.