Diabetes Watch

Pharmacy Times
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Diabetic Women Don?t Benefit from Drop in Death RatesAlthough the past 30 years have seen a reduction in heart disease and longer lives, the outcome does not pertain to women with diabetes.

The study, conducted by researchers at the Centers for Disease Control and Prevention and the National Institutes of Health, looked at death rates from 1971 to 2000. During that period, the death rates dropped significantly for men and women without diabetes. No decline was seen, however, for women with diabetes. The gap in death rates for all causes between women with diabetes and those without it more than doubled. (The findings were published online June 19, 2007, in the Annals of Internal Medicine.)

HDC Program Improves TreatmentThe Diabetes Health Disparities Collaborative (HDC) program has seen many improvements in diabetes care in its first 4 years. The study looked at the cost-effectiveness of improving diabetes care under the HDC. Data on the impact of the Diabetes HDC program were obtained in 1998, 2000, and 2002 from 17 Midwestern health centers.

The researchers found that many facets of care improved greatly from 1998 to 2002. For example, they saw improvements in the patients? blood sugar levels, cholesterol levels, kidney function, and vision. The lifetime occurrence of end-stage kidney disease dropped from 18% to 15%, and coronary artery disease levels also were lowered from 28% to 24%.

Reporting in Health Services Research (June 2007), the investigators said that the program cost per patient was $700 in the first year, $600 in the second, and $500 in the third. At the beginning of the fourth year, it leveled off to $378. The researchers noted that the average cost for diabetes complications is $10,000 per patient per year. Therefore, the major reductions in complications linked with the program make it very cost-effective.

EMRs Do Not Mean Improved CareThe push toward electronic medical records (EMRs) does not guarantee that patients with diabetes will see better care. To determine the impact of EMRs on the quality of care, the researchers culled data on the care of 927 patients with diabetes in 50 physicians? offices.

The findings, reported in the Annals of Family Medicine (May/June 2007), found that physician offices that used EMRs offered poorer quality of care, compared with those that did not use them. The researchers found that patient care in 37 offices without EMRs was more prone to meet guidelines for treatment and intermediate outcomes, compared with 13 offices using the technology.

?The question is, how do we translate these findings from big institutions with lots of resources out to where most of the care is being given,? said study author Jesse C. Crosson, PhD. ?The technology itself won?t enhance the process, but rather the people in practice working on ways to improve quality have to ask ?how can [we] use this tool???

Diabetes Curtails Life ExpectancyIndividuals diagnosed with diabetes can expect to lose an average of 8 years from their expected life span, found a study reported in the Archives of Internal Medicine (June 11, 2007).

The researchers based their conclusion on data from >5200 American men and women who participated in the ongoing Framingham Heart Study. The participants were tracked until they developed heart disease or died. The study results indicated that women with diabetes had more than 2 times the risk of developing heart disease, and women with diabetes who already had heart disease were more than twice as likely to die, compared with women without diabetes.

Of the men, those with diabetes also had twice the risk of developing heart disease and had 1.7 times greater risk of dying after developing heart trouble, compared with men without diabetes.

Seniors with Diabetes: Muscle Strength Rapidly DeclinesOlder individuals with type 2 diabetes lose muscle strength faster, compared with individuals without the disease, according to a study reported in the June 27, 2007, issue of Diabetes Care. The study focused on 1840 patients aged 70 to 79 years. Of the participants, 305 had type 2 diabetes.

For the study, the researchers investigated the leg and arm muscle mass and strength at the study?s onset and 3 years later. The findings indicated that the patients with diabetes showed statistically significant greater declines in leg muscle mass, compared with their counterparts. The results also showed that leg muscle strength and maximum leg muscle strength per unit of muscle mass also dropped more in the patients with diabetes. The researchers found no differences, however, in changes in arm muscle strength and quality between the 2 groups.

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