Better glucose control seen with group appointments for type 2 diabetes | Study looks at prevalence of diabetes in patients with HBV | Insulin sensitivity in prediabetes may improve with sildenafil
November 20, 2015
Family Medicine SmartBrief

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Better glucose control seen with group appointments for type 2 diabetes
Fifty percent of patients with type 2 diabetes achieved the target HbA1C goals when medical care was delivered through group medical appointments, compared with 19% of those who received usual primary care, according to a study in Diabetes Spectrum. Researchers used a cohort of 104 male patients and found a significantly faster rate of decline in hemoglobin A1C over time among those in the group medical appointments than in the usual primary care group. News (11/18)
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Clinical News
Study looks at prevalence of diabetes in patients with HBV
A study in Hepatology found 12.5% of patients with hepatitis B had diabetes, while 7.8% had impaired fasting glucose. Researchers used a cohort of 882 multi-ethnic HBV-infected adults in the US and Canada and found a prevalence of diabetes or IFG among 36.7% of blacks and 25.5% of those foreign born who migrated more than 20 years ago or lived in the US. Healio (free registration) (11/19)
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Insulin sensitivity in prediabetes may improve with sildenafil
Researchers found overweight adults with prediabetes had a greater insulin sensitivity index and higher disposition index three months after being treated with sildenafil 25 mg three times daily, compared with those on placebo. The findings in the Journal of Clinical Endocrinology and Metabolism, based on 42 adults, also revealed those on sildenafil had a decreased urine albumin-to-creatinine ratio, compared with an increase in the placebo group, and a significant reduction in plasminogen activator inhibitor-1. Healio (free registration)/Endocrine Today (11/18)
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Analysis examines antibiotic prescription in children with URI
A study in the Annals of Family Medicine showed a 93.5% overall rate for appropriate management of upper respiratory tract infections among children. Researchers evaluated data of 20,581 patients with URI, ages 3 months to 18 years, who were diagnosed from 2007 to 2012 and found family medicine clinicians and white race/ethnicity, as well as older patient age, were factors predictive of antibiotic prescription. News (11/19)
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Pediatric cancer survivors may have poorer mental, physical health as adults
Survivors of childhood brain cancer, leukemia and Hodgkin lymphoma had almost double the risk of being hospitalized up to 34 years after surviving the disease, according to a Danish study of over 33,000 young cancer survivors diagnosed between 1943 and 2004. A second study, based on 119 people, revealed adults who had survived osteosarcoma, a type of bone cancer, had lower scores on attention, memory and reading tests and a slower brain processing speed than those who didn't have cancer as children. Both studies were published online in JAMA Oncology. HealthDay News (11/19)
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Practice Management
Expert suggests ways to secure EHRs during transition to cloud
Moving EHRs to the cloud may be beneficial to health care organizations, but it could also put patient data at risk if it's not effectively done, writes Digital Guardian Chief Technology Officer Salo Fajer. In addition to assessing whether current information policies are still applicable to cloud data, Fajer suggests that organizations examine present usage of cloud storage to spot inappropriately saved information. For example, test systems on-site, look closely at long-term costs, involve those responsible for data entry and access, set credible expectations for use and closely consider what information should be kept on the cloud, including what data would require encryption, Fajer says. (11/18)
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Health Policy & Legislation
Congress to consider overhaul of military health care system
The Senate and House Armed Services committees are planning a systematic review of military health care programs, which could include moving non-active-duty Tricare beneficiaries to civilian insurance plans and improving care for Reserve and National Guard forces. Reforms would also address issues related to Tricare coverage. Military Times (11/17)
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Bill would pay Medicare recipients for completing advance directive
Bipartisan legislation would give Medicare patients a small financial payment if they give physicians and family clear legal guidance on their care preferences should they become incapacitated. The Medicare Choices Empowerment and Protection Act also would provide a website telling Medicare patients they can decide to reject or accept medical care based on their values. The Examiner (Washington, D.C.) (11/19)
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FDA nominee addresses industry ties in confirmation hearing
In a Senate confirmation hearing, Robert Califf, M.D., President Obama’s nominee to head the FDA, stressed the transparency of his research contracts with drug companies while director of the Duke Clinical Research Institute. Despite concerns over his industry ties, Califf's nomination is expected to receive approval. The New York Times (free-article access for SmartBrief readers) (11/18)
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Inside the AAFP
They're (usually) not doctors, but they play them on TV
Fresh Perspectives
When it comes to medicine, TV programs often get it all wrong. Will a crop of new shows making their respective debuts this fall be any different? Margaux Lazarin, D.O., M.P.H., has more in the latest Fresh Perspectives blog post.
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About AAFP
This news roundup is provided as a timely update to AAFP members and other health care professionals about family medicine topics in the news media. Links to articles are provided for the convenience of family physicians who may find them of use in discussions with patients or colleagues. Opinions expressed in Family Medicine SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American Academy of Family Physicians. On occasion, media articles may include or imply incorrect information about the AAFP and its policies, positions or relationships. For clarification on AAFP positions and policies, we refer you to
External Resources are not a part of the AAFP website. AAFP is not responsible for the content of sites that are external to the AAFP. Linking to a website does not constitute an endorsement by AAFP of the sponsors of the site or the information presented on the site.

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