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Showing posts with label Diabetes. Show all posts
Showing posts with label Diabetes. Show all posts

Wednesday, November 29, 2017

The Hype of Virtual Medicine

Ezekiel J. Emanuel
The Wall Street Journal
Originally posted Nov. 10, 2017

Here is an excerpt:

But none of this will have much of an effect on the big and unsolved challenge for American medicine: how to change the behavior of patients. According to the Centers for Disease Control and Prevention, fully 86% of all health care spending in the U.S. is for patients with chronic illness—emphysema, arthritis and the like. How are we to make real inroads against these problems? Patients must do far more to monitor their diseases, take their medications consistently and engage with their primary-care physicians and nurses. In the longer term, we need to lower the number of Americans who suffer from these diseases by getting them to change their habits and eat healthier diets, exercise more and avoid smoking.

There is no reason to think that virtual medicine will succeed in inducing most patients to cooperate more with their own care, no matter how ingenious the latest gizmos. Many studies that have tried some high-tech intervention to improve patients’ health have failed.

Consider the problem of patients who do not take their medication properly, leading to higher rates of complications, hospitalization and even mortality. Researchers at Harvard, in collaboration with CVS, published a study in JAMA Internal Medicine in May comparing different low-cost devices for encouraging patients to take their medication as prescribed. The more than 50,000 participants were randomly assigned to one of three options: high-tech pill bottles with digital timer caps, pillboxes with daily compartments or standard plastic pillboxes. The high-tech pill bottles did nothing to increase compliance.

Other efforts have produced similar failures.

The article is here.

Sunday, July 28, 2013

Peter Attia: What if we're wrong about diabetes?

As a young ER doctor, Peter Attia felt contempt for a patient with diabetes. She was overweight, he thought, and thus responsible for the fact that she needed a foot amputation. But years later, Attia received an unpleasant medical surprise that led him to wonder: is our understanding of diabetes right? Could the precursors to diabetes cause obesity, and not the other way around? A look at how assumptions may be leading us to wage the wrong medical war.




Saturday, December 3, 2011

Antipsychotic drugs tied to diabetes risk in kids

By Amy Norton
Reuters/Yahoo! News

The antipsychotic drugs that are increasingly being used to treat bipolar disorder, autism and other mental disorders in children may come with an increased risk of diabetes, a new study suggests.

Previous research has linked the so-called second-generation antipsychotics to an increased risk of diabetes in adults. And there's been some evidence that the drugs can cause weight gain in children.

The new findings, published in the journal Pediatrics, add to concerns that the medications may ultimately lead to diabetes in some kids.

Using records from three U.S. health plans, researchers found that children and teens who started on an antipsychotic had four times the risk of being diagnosed with diabetes, versus kids not using any psychiatric medication.

They developed diabetes at a rate of just over three cases per 1,000 children per year. That compared with just under 0.8 cases per 1,000 among medication-free kids.

Second-generation antipsychotics include drugs such as Risperdal, known generically as risperidone, Zyprexa (olanzapine), Seroquel (quetiapine) and Abilify (aripiprazole).

The drugs are used to treat conditions like bipolar disorder, schizophrenia and irritability and aggression in children with autism. They are also sometimes given to children with attention-deficit hyperactivity disorder (ADHD), even though there's no research evidence to support that.

The entire story is here.

Saturday, November 5, 2011

Many Don't Believe Their Obesity is Unhealthy

By Jenifer Goodwin
Health Daily Reporter
MedicineNet.com

Many overweight and obese patients seen in hospital emergency departments don't believe their weight poses a risk to their health, and many say doctors have never told them otherwise, a new study finds.

Researchers asked 450 randomly selected patients who were seen in the emergency department at Shands at the University of Florida two questions: Do you believe your present weight is damaging to your health, and has a doctor or other health professional ever told you that you are overweight?

Of those who reported that their weight was unhealthy, only 19% said they'd ever discussed it with a health care provider. And only 30% of those who reported being told by their health care provider that their weight was unhealthy agreed with that opinion, according to the study.

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Ryan recommends that patients leave the ER with referrals to dieticians and other weight-loss specialists, and that primary care doctors make sure to take the time to broach the issue with patients.

Gans agreed. Though emergency room physicians are pressed for time, when patients are sick and worried about their health may be an opportune moment to encourage changes.

"Unfortunately nothing happens until a patient becomes fearful," Gans said. "I see that all too often. I'll ask them, 'Do you need to wait until you have diabetes until you start to lose weight? Do you need to suffer a heart attack? And some people will actually say 'Yes.'"

The whole story can be read here.