Type 2 diabetes patients with established atherosclerotic cardiovascular disease who don't meet glycemic targets with metformin and lifestyle modification should be given a glucose-lowering drug with proven cardiovascular benefit and/or mortality reduction, such as liraglutide or empagliflozin, according to the American Diabetes Association's 2018 guidelines published in Diabetes Care. Children and adolescents who are overweight or obese and have one or more additional risk factors should also be screened for prediabetes and type 2 diabetes, the ADA recommends.
A study in Diabetes Care showed that homeostatic model assessment of insulin resistance, two-hour glucose, fasting insulin, C-reactive protein, triglycerides and waist circumference were negatively associated with moderate-to-vigorous physical activity among patients with prediabetes. UK researchers used a cohort of 2,326 adults and found positive correlations between sedentary time and HOMA-IR, fasting insulin, systolic and diastolic blood pressure, C-reactive protein, triglycerides and waist circumference.
Surgery of any kind raises the risk of perioperative myocardial injury in older patients and in patients with heart disease, but the condition has subtle symptoms and is often missed, researchers reported in Circulation. A high-sensitivity troponin test can detect the condition, and researcher and cardiologist Christian Puelacher says management strategies should be tailored to the patient.
A study at the San Antonio Breast Cancer Symposium found that women who lose 5% or more of their body weight after menopause may reduce their risk of breast cancer by about 12%. Weight gain after menopause was associated with an increase in the risk for triple negative breast cancer.
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Two-thirds of high-risk infants who were age-eligible for routine pentavalent human-bovine reassortant rotavirus vaccination weren't immunized before hospital discharge, 42.6% of whom were no longer age-eligible after discharge, researchers reported in Pediatrics. The findings also showed no transmission of vaccine-type rotavirus between vaccinated and unvaccinated babies, and researchers suggested that postponing rotavirus immunization until discharge may result in missed vaccination opportunities.
German researchers analyzed data from 71 patients with cystic fibrosis-related diabetes, ages at least 10, and found no between-group differences for the number of patients with an HbA1C of 7% or less among those on oral repaglinide and those on insulin at 12 months and 24 months. The findings in The Lancet Diabetes & Endocrinology also revealed no differences in hypoglycemic events or in mean blood glucose concentration between the groups.
A study estimated the number of US Alzheimer's disease cases will double by 2060, and author Ron Brookmeyer said it highlights the need for ways to better identify people who will develop the disease and for new interventions to slow or stop disease progression. The research, published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, found that about 5.7 million people will have mild cognitive impairment and 9.3 million will have Alzheimer's disease by 2060.
A survey by the Institute for Safe Medication Practices found that nearly half of 778 health care providers polled said they used device encryption when receiving texted medical orders. Researchers also found that phone/device autocorrection resulting in incorrect drug or patient names was the top concern with texting orders, followed by confusing abbreviated text terminology and patient misidentification.
Sen. Susan Collins, R-Maine, said she has yet to decide whether to support the final tax bill being negotiated by House and Senate leaders after House Speaker Paul Ryan, R-Wis., indicated he was not bound by Collins' health care deal with Senate GOP leaders. Collins voted earlier this month for a tax bill that included a repeal of the Affordable Care Act's individual mandate after receiving a commitment from Senate Majority Leader Mitch McConnell, R-Ky., that he would work for passage of bills designed to stabilize insurance markets.
Researchers found that the number of infant critical congenital heart disease deaths in eight states with mandatory newborn CHD screening decreased by 33.4% between 2007 and 2013, while the number of infant deaths from other or unspecified cardiac causes dropped by 21.4% during the same period, compared with nonsignificant declines in states without mandatory newborn CHD screening policies. The findings were published in the Journal of the American Medical Association.