Diabetes

Formularies of the future should use evidence-produced CER to better target, not limit, diabetes care.

To act as a catalyst for ideas, partnerships, and collaboration among all stakeholders to provoke thought, innovation, and action to address the cost, productivity, and quality-of-life impact of diabetes, obesity, and related conditions and comorbidities on our society, Joslin Diabetes Center convened Diabetes Innovation for the first time in 2012. Highlights from Diabetes Innovation, which took place on September 23-25 2012, in Arlington, Virginia, are available in a special report published by The American Journal of Managed Care.

The management of type 2 diabetes mellitus (T2DM) remains challenging. Limitations associated with many current therapies include hypoglycemia and weight gain. An increased understanding of the pathophysiology of T2DM has led to the development of incretin-related antihyperglycemic therapies.

The aDCSI without the inclusion of laboratory data performs similarly to the DCSI with laboratory results, and is a good measure of diabetes severity.

The heterogeneous nature of care processes and patients should be taken into account in both the design and evaluation of disease management programs for diabetes.

In this video, Feng Zeng, PhD, Senior Health Economist, MedImpact, discusses how the implementation of copayment reduction in the gap in 2011 influenced adherence measures for oral diabetes medications.

We examined the impact of clinical complexity defined by comorbidity count and illness burden on comprehensive diabetes care, including blood pressure, glycemic, and lipid management.

This study shows how cardiovascular prevention would be much more efficient if risk were used in treatment decisions, but that currently it plays no role.

Racial disparities are widespread in healthcare. Disparities can have a strong influence on diabetes care. This manuscript explores the source of such disparities.

Gender differences were found in healthcare utilization in patients with type 2 diabetes mellitus in Germany, despite a high rate of enrollment in a disease management program.

Keith Dunleavy, MD, President and CEO, Inovalon, addresses the importance of healthcare data and the digitization of medicine. Dr. Dunleavy states that having quality data allows for more accurate care on an individual level, along with cost savings and a better risk score.

In this video, Margaret Powers, PhD, talks about obesity's impact on the management of chronic illnesses. Dr. Powers also talks about the benefits of obese patients losing 5% to 7% of body weight and working out 150 minutes a week to lower their risk of developing diabetes and other chronic conditions.

Some studies have found that individuals with diabetes have a heightened risk of morbidity and premature death associated with macrovascular complications among smokers. In this study, researchers tested an educational, interventional program led by non-doctor health professionals in order to assist adult male diabetes patients to quit smoking.

In this video, Felicia Hill-Briggs, PhD, speaks about the importance of patient-reported outcomes in improving the effectiveness of specific interventions and treatments. Hill-Briggs also talks about the role of comparative effectiveness in patient-reported outcomes.

The following are highlights of late-breaking abstracts that were on display at the ADA's 72nd Scientific Sessions in Philadelphia, PA. The abstracts were submitted after April 2012.

Diabetes is a condition that has many variables. Researchers are finding more and more about how genetics and patient behavior play a role; however, it turns out that socioeconomic status, education, and ethnic background all play a role as well.

Allison Rosen, MD, ScD, talks about using value-based insurance design as an incentive to improve type 2 diabetes outcomes.

Simon Heller, MB, DM, discusses the various ways hypoglycemia can affect the cardiovascular system. Examples of these consequences are thrombosis, heart disease, and myocardial infarction.

Monday morning at the ADA's 72nd Scientific Sessions featured the National Scientific & Health Care Achievement Awards Presentation and Outstanding Scientific Achievement Award Lecture. This year's recipient of the Outstanding Scientific Achievement Award was David Altshuler, MD, PhD, Professor of Medicine and Genetics at Harvard Medical School and Massachusetts General Hospital, Boston, for his work on genetic-based research regarding the inherited basis of type 2 diabetes, cholesterol levels, myocardial infarction, and a number of other conditions.

Roman Hovorka, PhD, talks about the prohibitive costs in continuous glucose monitoring. He states that if these costs can be reduced there will be wider acceptance and therefore a benefit to diabetes care.

Dr. Margaret Powers says that currently genetic testing does not motivate behavior change and weight loss in diabetes care. Patients who did not receive the test did just as well with behavior changes as patients who knew they were high risk through genetic testing.