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Poor glycemic control linked to potential risk for heart failure
Improving glycemic control may help prevent heart failure, according to a recent study published in The Lancet. The study enrolled at 20,985 patients with type 1 diabetes to assess variables associated with cardiovascular disease, including age, sex, duration of diabetes, HbA1c, body mass index, systolic and diastolic blood pressure, LDL and HDL cholesterol, and smoking status.
Improving glycemic control may help prevent heart failure, according to a recent study published in The Lancet. The study enrolled at 20,985 patients with type 1 diabetes to assess variables associated with cardiovascular disease, including age, sex, duration of diabetes, HbA1c, body mass index, systolic and diastolic blood pressure, LDL and HDL cholesterol, and smoking status.
Investigators identified the cohort of patients with type 1 diabetes from the Swedish National Diabetes Registry (NDR). Patients were aged 18 years or older with no known heart failure and were registered between January, 1998, and December, 2003. The patients were followed from their first inclusion in the NDR in 1998 to 2003 until hospital admission with a primary or secondary discharge diagnosis for heart failure, death, or the end of follow-up on Dec. 31, 2009.
The 2 key findings of the study were that 635 (3%) patients needed to be admitted to hospital for heart failure, with an incidence of 3.38 events per 1,000 patient-years. In addition, patients with HbA1c of at least 10.5% had a risk of heart failure 4 times greater than did those with HbA1c less than 6.5%. In their analysis of mean HbA1c as a continuous variable, each 1% increase was associated with a 30% higher risk of heart failure during follow-up, independently of other risk factors for heart failure.
The authors noted that the high incidence of heart failure among study participants, despite the young mean age at inclusion (38.6 years), and the substantially increased risk because of poor glycemic control indicates an independent role of glycemic control in the pathogenesis of heart failure.
“Because treatment for heart failure improves survival and quality of life, clinicians should be observant of signs of heart failure in management of patients with type 1 diabetes, starting at an early stage.”
The study was supported by an unrestricted grant from AstraZeneca, Novo Nordisk Scandinavia, the Swedish Heart and Lung Foundation, and the Swedish Research Council; however supporting organizations had no involvement in protocol design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit the report for publication, the authors stated.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
