Here are what the editors at HealthDay consider to be the most important developments in Diabetes & Endocrinology for July 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.
Learning to Change Important for Improving Practice
TUESDAY, July 31, 2018 (HealthDay News) — Although physicians typically struggle with change, relying on habits created in their practice, learning to change is important in order to improve practices and better deal with the changes sweeping through medicine, according to an article published in Medical Economics.
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FDA Approves Azedra for Rare Adrenal Tumors
TUESDAY, July 31, 2018 (HealthDay News) — Azedra (iobenguane) has been approved by the U.S. Food and Drug Administration to treat people 12 and older with rare adrenal gland tumors (pheochromocytoma or paraganglioma) that can’t be surgically removed and have spread beyond the original site.
Front Desk Staff Can Set Up a Practice for Successful Billing
TUESDAY, July 31, 2018 (HealthDay News) — Allowing front desk staff adequate time and an uninterrupted environment to focus on billing can prevent problems later on, according to an article published in Physicians Practice.
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One in Four Older Adults With Diabetes Uses Alternative Meds
TUESDAY, July 31, 2018 (HealthDay News) — More than 25 percent of older U.S. adults with diabetes use some type of complementary and alternative medicine (CAM), according to a research letter published in the June issue of Diabetes Care.
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Few Published Programs Address Medical Trainee Mistreatment
TUESDAY, July 31, 2018 (HealthDay News) — There are very few published descriptions of programs that address the mistreatment of medical trainees, according to a review published online July 27 in JAMA Network Open.
Medical Boards May Contribute to Mental Health Stigma for Doctors
MONDAY, July 30, 2018 (HealthDay News) — Existing policy has been amended to encourage licensing boards to require disclosure of physical or mental health conditions only when these would negatively impact a physicians’ ability to practice medicine, according to an article published in the American Medical Association’s AMA Wire.
Four Strategies Help Doctors Make Personal, Professional Gains
MONDAY, July 30, 2018 (HealthDay News) — In an article published in Physicians Practice, four strategies are presented to help physicians make personal and professional gains.
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Health Coverage Interruptions Common in Adults With T1DM
MONDAY, July 30, 2018 (HealthDay News) — Interruptions in private health insurance coverage are common among U.S. adults with type 1 diabetes and are associated with an increase in glycated hemoglobin and in use of acute care services, according to a report published in the July issue of Health Affairs.
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Young Cancer Survivors Have High Risk of Endocrine Diseases
MONDAY, July 30, 2018 (HealthDay News) — Adolescent and young adult cancer survivors have a 73 percent higher risk of endocrine diseases, according to a study published online June 29 in JAMA Network Open.
Cross-Continuum Communication Beneficial After Discharge
FRIDAY, July 27, 2018 (HealthDay News) — Cross-continuum communication after hospital discharge can improve patient outcomes and overall health, according to an article published in Physicians Practice.
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Risk of Heart Failure Up in ALVSD Patients With Diabetes
FRIDAY, July 27, 2018 (HealthDay News) — For patients with asymptomatic left ventricular systolic dysfunction (ALVSD), those with diabetes have increased risk of heart failure development and hospitalization, according to a study published in the June issue of Diabetes Care.
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Drop in Osteoporosis Treatment Initiation After Hip Fracture
FRIDAY, July 27, 2018 (HealthDay News) — In recent years there have been low rates of osteoporosis treatment initiation after a hip fracture, according to research published in the July 20 issue of JAMA Network Open.
Assessing, Improving Patient Satisfaction Cuts Malpractice Risk
THURSDAY, July 26, 2018 (HealthDay News) — Assessing and improving patient satisfaction can help physicians avoid being sued for malpractice, according to an article published in Physicians Practice.
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Insurers May Be Underpaying Doctors
THURSDAY, July 26, 2018 (HealthDay News) — Insurance companies sometimes underpay doctors the contracted amount for a service or procedure, according to an article published in Medical Economics.
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Diabetes Diagnosis May Impact Health Behaviors of Family
WEDNESDAY, July 25, 2018 (HealthDay News) — Partners of people with newly diagnosed diabetes have small but significant differences in health-related behavioral changes compared with partners of people without diabetes, according to a study published in the July/August issue of the Annals of Family Medicine.
Tools, Methods of RCTs Can Be Adapted to Real-World Settings
WEDNESDAY, July 25, 2018 (HealthDay News) — Use of appropriate statistical methodology can allow for the synthesis of data collected as part of traditional clinical trials with real-world data, according to an Ideas and Opinions piece published online July 24 in the Annals of Internal Medicine.
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Physicians and Practices Should Prepare for Emergencies
TUESDAY, July 24, 2018 (HealthDay News) — Practices and physicians should prepare for emergency situations, such as natural disasters, network communications failures, and active shooter situations, according to an article published in Medical Economics.
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VA MISSION Act May Up Costs, Lower Vet Health Care Quality
TUESDAY, July 24, 2018 (HealthDay News) — The Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act may increase costs and reduce quality of health care for veterans, according to an Ideas and Opinions piece published online July 24 in the Annals of Internal Medicine.
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Child Health Concerns Related to Use of Food Additives
TUESDAY, July 24, 2018 (HealthDay News) — Regulatory changes are needed to address child health concerns related to the use of food additives, according to a policy statement published online July 23 in Pediatrics.
Policy Statement
Technical Report
Sulfonylureas As 2nd-Line T2DM Therapy Tied to Higher Event Risk
TUESDAY, July 24, 2018 (HealthDay News) — Sulfonylureas as second-line drugs for type 2 diabetes are associated with an increased risk of cardiovascular and hypoglycemic events compared with remaining on metformin monotherapy or adding to metformin therapy, according to a study published online July 18 in The BMJ.
Walmart Generic Drug Discounts Often Offer More Patient Savings
MONDAY, July 23 2018 (HealthDay News) — Walmart’s Generic Drug Discount Program (GDDP), which sells many commonly used generic medications for $4 per 30-day supply, offers savings over Medicare for some generic cardiovascular medications, according to a research letter published online July 24 in the Annals of Internal Medicine.
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Medical Organizations Must Address Sexual Harassment
MONDAY, July 23, 2018 (HealthDay News) — Medical institutions and organizations need to ensure there are proactive interventions to transform the workplace in order to address sexual harassment and discrimination, according to an article published in the American Medical Association’s AMA Wire.
Intermittent Energy Restriction Effectively Cuts HbA1c in T2DM
MONDAY, July 23, 2018 (HealthDay News) — For patients with type 2 diabetes, intermittent energy restriction is comparable to continuous energy restriction for reduction of hemoglobin A1c (HbA1c), according to a study published online July 20 in JAMA Network Open.
Embezzlement Not Uncommon in Medical Practices
MONDAY, July 23, 2018 (HealthDay News) — Embezzlement occurs frequently in medical practices and steps should be taken to prevent it, according to an article published in Medical Economics.
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Increased Coverage in States With Medicaid Expansion
FRIDAY, July 20, 2018 (HealthDay News) — Coverage rates and access to care are significantly higher in states with Medicaid expansion, compared with non-expansion states, according to a study published in the July issue of Health Affairs.
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Empagliflozin Doesn’t Up Risk of Bone Fractures
FRIDAY, July 20, 2018 (HealthDay News) — Empagliflozin does not increase the risk of bone fracture in patients with type 2 diabetes, according to a study published online June 15 in Diabetes Care.
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FDA Proposes New Rule on Food Labeling in Vending Machines
FRIDAY, July 20, 2018 (HealthDay News) — A new rule proposed by the U.S. Food and Drug Administration suggests that the type size on packaged foods sold in vending machines be at least 1.5 times the size of the net weight declaration on the front of the package.
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Same-Day Appointment System Implemented in Health Network
THURSDAY, July 19, 2018 (HealthDay News) — A same-day appointment system can feasibly be introduced, according to the experiences of one health network presented in an article published in Managed Healthcare Executive.
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Characteristics of Severe Hypoglycemia Identified in T2DM
THURSDAY, July 19, 2018 (HealthDay News) — For patients with type 2 diabetes, characteristics of those with severe hypoglycemia include having a prior diagnosis of non-severe hypoglycemia and hemoglobin A1c (HbA1c) <6 percent, according to a study published in the June issue of Diabetes Care.
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Patients Care About the Clothes Doctors Wear
THURSDAY, July 19, 2018 (HealthDay News) — Patients do in fact care what doctors wear, according to a study recently published in BMJ Open.
Seven Strategies Can Help Practices Manage Staff Time Off
WEDNESDAY, July 18, 2018 (HealthDay News) — Several strategies can be implemented to help address management of staff time off, allowing mutual respect for the employee and employer requests, according to an article published in Medical Economics.
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Basal Insulin Analogues Similar for Glucose Lowering
WEDNESDAY, July 18, 2018 (HealthDay News) — Basal insulin analogues for type 2 diabetes mellitus (T2DM) do not substantially differ in their glucose-lowering effect, according to a review published online July 10 in the Annals of Internal Medicine.
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CDC: ‘Tips’ Campaign Has Helped a Number of Smokers Quit
WEDNESDAY, July 18, 2018 (HealthDay News) — The ongoing Tips from Former Smokers (Tips) campaign, which features stories of former smokers living with smoking-related diseases and disabilities, has had a considerable impact, according to a report from the U.S. Centers for Disease Control and Prevention.
Impact of the Campaign
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Testosterone Prescribing Down Since 2013
WEDNESDAY, July 18, 2018 (HealthDay News) — The percentage of U.S. men receiving testosterone prescriptions decreased from 2013 through 2016, according to a research letter published in the July 10 issue of the Journal of the American Medical Association.
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Risk of CRC, Non-CRC Death Up With Positive Fecal Hb Test
WEDNESDAY, July 18, 2018 (HealthDay News) — Individuals with a positive fecal hemoglobin (f-Hb) test result have an increased risk of dying from colorectal cancer (CRC) and non-CRC causes, according to a study published online July 16 in Gut.
Alternative Payment Models Should Include Precision Medicine
TUESDAY, July 17, 2018 (HealthDay News) — The American Medical Association has committed to working to integrate precision medicine into alternative payment models (APMs), according to an article published in the association’s AMA Wire.
Trials Supporting FDA Approval of Breakthrough Drugs Examined
TUESDAY, July 17, 2018 (HealthDay News) — Pivotal trials supporting U.S. Food and Drug Administration approvals granted Breakthrough Therapy designation often lack randomization, double-blinding, and control groups, according to a research letter published in the July 17 issue of the Journal of the American Medical Association.
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Evidence of Clinical Inertia in Management of T2DM
TUESDAY, July 17, 2018 (HealthDay News) — Many patients with type 2 diabetes (T2D) who have a hemoglobin A1c (HbA1c) level expected to trigger treatment intensification often have treatment inappropriately delayed, according to a research letter published in the July issue of Diabetes Care.
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FDA Establishes New Task Force on Drug Shortages
TUESDAY, July 17, 2018 (HealthDay News) — In a recent statement, U.S. Food and Drug Administration Commissioner Scott Gottlieb, M.D., announced the formation of a new drug shortages task force to thoroughly explore the reasons why drug shortages remain a persistent challenge.
Adoption of EHR Linked to Reduction in Mortality Rates
MONDAY, July 16, 2018 (HealthDay News) — Adoption of electronic health records (EHRs) is associated with a reduction in mortality rates in U.S. hospitals, according to a study published in the July issue of Health Affairs.
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eCare Plan Set to Improve Doctor/Pharmacist Relationship
MONDAY, July 16, 2018 (HealthDay News) — The Pharmacist eCare Plan is designed to improve communication between pharmacists and physicians by allowing documentation to be available via electronic health records (EHRs), according to an article published online in Drug Topics.
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Physician Burnout Tied to Higher Risk of Medical Errors
MONDAY, July 16, 2018 (HealthDay News) — Physician burnout, fatigue, and work-unit safety grades are independently associated with medical errors, according to a study published online July 9 in the Mayo Clinic Proceedings.
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PM2.5 Contributes to Burden of Diabetes Mellitus Globally
MONDAY, July 16, 2018 (HealthDay News) — Particulate matter (PM) with a diameter of less than 2.5 micrograms per cubic meter of air (PM2.5) makes a substantial contribution to the burden of diabetes, according to a study published in the July issue of The Lancet Planetary Health.
Virtual Assistants Not HIPAA Compliant
FRIDAY, July 13, 2018 (HealthDay News) — Virtual assistant programs like Google Assistant, Siri, and Alexa are not yet in compliance with the Health Insurance Portability and Accountability Act (HIPAA), warns an article published in Medical Economics.
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Two Regimens Fail to Stop Declines in β-Cell Function
FRIDAY, July 13, 2018 (HealthDay News) — Neither glargine followed by metformin nor metformin alone halts the progressive deterioration of β-cell function in youth with impaired glucose tolerance (IGT) or recently-diagnosed type 2 diabetes, according to a study published online June 25 in Diabetes Care.
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Gender Bias in Medicine Has Far-Reaching Consequences
FRIDAY, July 13, 2018 (HealthDay News) — Overlooking women in medicine can have far-reaching consequences, according to a perspective piece published in the June 14 issue of the New England Journal of Medicine.
AMA Aims to Boost Affordability of ACA Marketplace Plans
THURSDAY, July 12, 2018 (HealthDay News) — The American Medical Association (AMA) House of Delegates has adopted policy to increase the number of people who obtain coverage through the Affordable Care Act (ACA) by making marketplace plans more affordable.
2001 to 2015 Saw Decline in Self-Employment in Health Care
THURSDAY, July 12, 2018 (HealthDay News) — From 2001 to 2015 there was a decrease in the percentage of health care professionals who are self-employed and a decrease in the earning gap between self-employed and employed health care professionals, according to a study published online July 12 in JAMA Network Open.
Patient Experience Officers Can Play Key Role in Medical Offices
THURSDAY, July 12, 2018 (HealthDay News) — A patient experience officer is an increasingly important new role in physician practices, according to an article recently published in Physicians Practice.
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Basal Insulin Analogs Don’t Cut Hypoglycemia-Linked ER Visits
THURSDAY, July 12, 2018 (HealthDay News) — Initiation of a basal insulin analog versus human neutral protamine Hagedorn (NPH) insulin is not associated with reduction in the risk of hypoglycemia-related emergency department visits or hospital admissions, according to a study published in the July 3 issue of the Journal of the American Medical Association.
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Mothers’ Healthy Lifestyle Tied to Drop in Offspring Obesity
THURSDAY, July 12, 2018 (HealthDay News) — Adherence to a healthy lifestyle among mothers during their offspring’s childhood is associated with reduced risk of childhood obesity, according to a study published online July 4 in The BMJ.
Peer-Led Education Helps Physicians Save Time With EHRs
THURSDAY, July 12, 2018 (HealthDay News) — A peer-based education program can improve the efficiency of electronic health record (EHR) use, according to an article published in the American Medical Association’s AMA Wire.
Metformin Tied to Acidosis Risk at eGFR <30mL/min/1.73 m²
WEDNESDAY, July 11, 2018 (HealthDay News) — Metformin use is associated with an increased risk of acidosis at estimated glomerular filtration rate (eGFR) <30mL/min/1.73 m², according to a study published in the July issue of JAMA Internal Medicine.
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FDA Requires Safety Label Changes for Fluoroquinolones
WEDNESDAY, July 11, 2018 (HealthDay News) — The U.S. Food and Drug Administration has strengthened current warnings in the prescribing information about fluoroquinolone antibiotics causing significant decreases in blood glucose as well as mental health side effects.
Press Release
Safety Announcement
Circadian System, Misalignment Have Distinct Impact on Insulin
WEDNESDAY, July 11, 2018 (HealthDay News) — The endogenous circadian system, behavioral cycle, and circadian misalignment have distinct effects on insulin sensitivity and β-cell function, according to a study published online June 4 in Diabetes, Obesity and Metabolism.
International Group Develops Best Practices for Drug Packaging
TUESDAY, July 10, 2018 (HealthDay News) — Nine new drug labeling and packaging guidelines have been developed with an aim of reducing medication errors, according to a report published in Drug Topics.
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AMA Calls for Inclusive Family, Medical Leave Policies
TUESDAY, July 10, 2018 (HealthDay News) — The American Medical Association (AMA) calls for inclusive family and medical leave policies to support lesbian, gay, bisexual, transgender, and queer (LGBTQ) workers who care for relatives, spouses, and partners.
Error Rate 7.4 Percent in Speech Recognition-Assisted Notes
TUESDAY, July 10, 2018 (HealthDay News) — The error rate in speech recognition (SR)-assisted documentation is 7.4 percent, according to a study published online July 6 in JAMA Network Open.
Programs Can Lower Diabetes Distress in Adults With T1DM
TUESDAY, July 10, 2018 (HealthDay News) — Both education/behavioral and emotion-focused approaches can effectively reduce diabetes distress (DD) among patients with type 1 diabetes (T1D) and elevated hemoglobin A1c (HbA1c), according to a study published online July 5 in Diabetes Care.
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Transfeminine Persons Have Increased VTE Incidence
TUESDAY, July 10, 2018 (HealthDay News) — Transfeminine individuals have increased rates of venous thromboembolism (VTE) compared with cisgender men and cisgender women, with more pronounced differences for those initiating hormone therapy, according to research published online July 10 in the Annals of Internal Medicine.
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Obesity Paradox Seen in T2DM Modified by Smoking Status
MONDAY, July 9, 2018 (HealthDay News) — Smoking status heavily modifies the obesity paradox observed in people with type 2 diabetes, according to a study published online July 3 in Diabetes Care.
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IT Solutions for Easier EHRs Save Physicians Time, Burnout
FRIDAY, July 6, 2018 (HealthDay News) — Yale Medicine is effectively targeting electronic health record (EHR) use and functionality as a way to improve physician job satisfaction and reduce burnout, according to an article published in the American Medical Association’s AMA Wire.
Health Gains, Cost Savings Projected for Sodium Goals
FRIDAY, July 6, 2018 (HealthDay News) — Substantial health gains and cost savings could be achieved with implementation and achievement of the U.S. Food and Drug Administration sodium reformulation targets, according to a study recently published in PLOS Medicine.
Travel Costs Are Considerable Part of T2DM Follow-Up Costs
FRIDAY, July 6, 2018 (HealthDay News) — For patients with type 2 diabetes mellitus (T2DM), travel costs relating to hemoglobin A1c (HbA1c) screening constitute a substantial cost item, and self-monitoring can reduce costs, according to a study published in the July issue of the International Journal of Medical Informatics.
Patisiran, Inotersen Aid Hereditary Transthyretin Amyloidosis
THURSDAY, July 5, 2018 (HealthDay News) — For patients with hereditary transthyretin amyloidosis with polyneuropathy, an investigational RNA interference therapeutic agent (patisiran) and a 2′-O-methoxyethyl-modified antisense oligonucleotide (inotersen), which inhibits hepatic production of transthyretin, improve clinical manifestations of disease, according to two studies published in the July 5 issue of the New England Journal of Medicine.
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Hospitals Face $218B in Federal Payment Cuts From 2010 to 2028
THURSDAY, July 5, 2018 (HealthDay News) — Cumulative reductions in federal payments to hospitals from 2010 to 2028 are estimated to reach $218.2 billion, according to a study commissioned by the Federation of American Hospitals and the American Hospital Association (AHA).
Patient Complaints Mainly About Rudeness, Rushing, Reproach
THURSDAY, July 5, 2018 (HealthDay News) — Understanding patients’ complaints about practice can be instructive for physicians, according to an article published June 6 in Physicians Practice.
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WHO Calls for Renewed Effort to Combat Chronic Disease
THURSDAY, July 5, 2018 (HealthDay News) — The World Health Organization (WHO) Independent High-Level Commission has proposed six recommendations to address the growing epidemic of non-communicable diseases (NCDs), according to a report published online June 1 in The Lancet.
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22.9 Percent of U.S. Adults Meet Aerobic, Strength Activity Goals
THURSDAY, July 5, 2018 (HealthDay News) — In 2010 to 2015, 22.9 percent of U.S. adults aged 18 to 64 met the guidelines for both aerobic and muscle-strengthening activities during leisure-time physical activity (LTPA), according to a study published in the June 28 issue of the National Health Statistics Reports.
Patients Comfortable With Doctors Having Tattoos, Piercings
THURSDAY, July 5, 2018 (HealthDay News) — Patients do not appear to mind if doctors have tattoos or piercings, according to a study published online July 2 in the Emergency Medicine Journal.
1996 to 2013 Saw Large Increase in Diabetes Spending
THURSDAY, July 5, 2018 (HealthDay News) — In 2013, $101 billion was spent in the United States on diabetes, almost a three-fold increase since 1996, according to a study published in the July issue of Diabetes Care.
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Oral Insulin Choline, Geranate Ionic Liquid Shows Promise
TUESDAY, July 3, 2018 (HealthDay News) — An oral insulin formulation has been developed using choline and geranate (CAGE) ionic liquid, which significantly reduces blood glucose levels in vivo for a sustained period, according to a study published online June 25 in the Proceedings of the National Academy of Sciences.
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CVD Risk Up With Hypertensive Disorders of Pregnancy
TUESDAY, July 3, 2018 (HealthDay News) — Women with hypertensive disorders of pregnancy (HDP) in their first pregnancy have increased rates of chronic hypertension, type 2 diabetes mellitus, and hypercholesterolemia, according to a study published online July 3 in the Annals of Internal Medicine.
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Working >45 Hours Tied to Higher Diabetes Risk in Women
TUESDAY, July 3, 2018 (HealthDay News) — For women, working 45 hours or more per week is associated with increased risk of diabetes, according to a study published online July 2 in BMJ Open Diabetes Research & Care.
AMA Adopts Policy to Cut Sugar Sweetened Drink Consumption
TUESDAY, July 3, 2018 (HealthDay News) — At the annual meeting of the American Medical Association (AMA), a policy was adopted to reduce the consumption of sugar-sweetened beverages (SSBs) as a way to reduce the amount of sugar that Americans consume.
Intensive Management Program Benefits High-Risk Patients
MONDAY, July 2, 2018 (HealthDay News) — For high-risk patients, use of an intensive management program is associated with greater receipt of outpatient care with no increase in total costs, according to a study published in the June 19 issue of the Annals of Internal Medicine.
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FDA Expands Approval of Closed-Looped Insulin Delivery System
MONDAY, July 2, 2018 (HealthDay News) — Approval of the MiniMed 670G hybrid closed looped system for diabetes management has been expanded to include individuals aged 7 to 13 years with type 1 diabetes, according to a report published by the U.S. Food and Drug Administration (FDA).
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