ADA releases 2018 medical care standards for diabetes | Research examines efficacy of SGLT2 inhibitors, pioglitazone in reducing A1C | Study compares safety of injected, oral medications for gestational diabetes
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. "The standards of care are the primary resource for the optimal management of diabetes and include updated guidelines for diabetes diagnosis and for evidence-based prevention of diabetes and diabetes-related complications," said William Cefalu, ADA's chief scientific, medical and mission officer. He also said ADA plans to update the standards continually, as needed.
A study in the Journal of Diabetes Investigation showed that type 2 diabetes patients who received pioglitazone or SGLT2 inhibitors as add-ons to insulin therapy had a greater A1C reduction than those on placebo. Korean researchers conducted a meta-analysis of randomized controlled trials involving 7,226 patients and found that those in the SGLT2 inhibitor and pioglitazone groups also showed reduced fasting plasma glucose levels and insulin dose requirements, compared with the placebo groups.
Researchers evaluated 99 studies involving 13,816 pregnant women with gestational diabetes and infants born to mothers who had GD and found no differences in the risk for infant mortality, infant hypoglycemia or childhood adiposity at 18 months between women who received insulin injections or oral medications. The findings in Cochrane Database of Systematic Reviews also revealed no difference in the risk for type 2 diabetes development, preeclampsia or birth by cesarean section between those who received insulin and oral medications.
A study in Pediatrics that analyzed 31 G- and PG-rated movies from 2012 through to 2015 found they all promoted obesity or unhealthy food or beverage choices at least one time, and most had the themes throughout the film. Healthy foods often were linked to negative or neutral emotions, less nutritious foods were more likely to be cast in a positive way, and overweight and obese characters were depicted negatively.
Farm-to-school programs have boosted the number of students consuming fruits and vegetables, according to a study in the Journal of Nutrition Education and Behavior. Data show students at schools with such programs consume 37% more vegetables and 11% more fruit than before adoption of the program.
A pilot program for OurNotes, an initiative targeting patient-provider collaboration in writing clinical notes and care plans within a shared EHR, will begin in the spring at Beth Israel Deaconess Medical Center, the University of Colorado, the University of Washington and Dartmouth-Hitchcock Medical Center. Beth Israel, which uses its own EHR system, will aid in organizing and standardizing efforts with the other sites, which use Epic systems, said Dr. Matthew Germak of Beth Israel.
People who have health insurance under the Affordable Care Act and don't re-enroll by the Dec. 15 deadline will be automatically enrolled in the same plan or a similar one. Experts say that could leave people with a more costly plan they don't want, and they might not have a chance to change it as they have in the past.
Hospital and health system executives responding to a survey said they are interested in artificial intelligence, machine learning and other emerging technology, but they are not rushing to implement it. Instead, they want to improve current EHR systems, standardize IT platforms and strengthen cybersecurity protocols.