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10-Year Follow-up of Intensive Glucose Control in Type 2 Diabetes

10-Year Follow-up of Intensive Glucose Control in Type 2 Diabetes | 1- E-HEALTH by PHARMAGEEK - E SANTE par PHARMAGEEK | Scoop.it

During the United Kingdom Prospective Diabetes Study (UKPDS), patients with type 2 diabetes mellitus who received intensive glucose therapy had a lower risk of microvascular complications than did those receiving conventional dietary therapy. We conducted post-trial monitoring to determine whether this improved glucose control persisted and whether such therapy had a long-term effect on macrovascular outcomes.

Results Between-group differences in glycated hemoglobin levels were lost after the first year. In the sulfonylurea–insulin group, relative reductions in risk persisted at 10 years for any diabetes-related end point (9%, P=0.04) and microvascular disease (24%, P=0.001), and risk reductions for myocardial infarction (15%, P=0.01) and death from any cause (13%, P=0.007) emerged over time, as more events occurred. In the metformin group, significant risk reductions persisted for any diabetes-related end point (21%, P=0.01), myocardial infarction (33%, P=0.005), and death from any cause (27%, P=0.002).

Conclusions

Despite an early loss of glycemic differences, a continued reduction in microvascular risk and emergent risk reductions for myocardial infarction and death from any cause were observed during 10 years of post-trial follow-up. A continued benefit after metformin therapy was evident among overweight patients. (UKPDS 80; Current Controlled Trials number.


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Seth Bilazarian, MD's curator insight, October 8, 2013 9:36 AM

Amazing! Twenty five years ago the UKPDS published the follow-up of metformin in diabetes showing a benefit on heart attack and death even years after patients came off the drug.  Despite years of basic science and clinical research and billions of dollars spent on development of new therapies we still don't have a single other diabetes drug that reduces heart attack risk. Many drugs have been developed for blood sugar control but all have shown no benefit over placebo for reduction of heart attack risk for diabetics.  Only metformin.

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Grapevine beats online: Web ratings aren't key in choosing doctor

Grapevine beats online: Web ratings aren't key in choosing doctor | 1- E-HEALTH by PHARMAGEEK - E SANTE par PHARMAGEEK | Scoop.it

Geography and physician referral still top the Internet when it comes to patients' healthcare choices, but insurance coverage is by far the biggest driver when it comes to parents choosing a doctor for their children, according to a new national survey.


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Seth Bilazarian, MD's curator insight, February 20, 2013 2:55 PM

This is very sobering for enthusiasts of online rating since this survey is for selection of pediatrician. The population of "choosers" being tested here is largely young mothers who have a very high penetration of internet use and may be using digital sources of the grapevine (like Facebook) over the rating services.  I w ould think the reported effect would be even more pronouned if tested in a population of senior citizens.

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Health System Waste Tallied - Report and Infographic from Institute of Medicine

Health System Waste Tallied - Report and Infographic from Institute of Medicine | 1- E-HEALTH by PHARMAGEEK - E SANTE par PHARMAGEEK | Scoop.it

Infographic has harsh data on use of information technology, making healthcare safer & more transparent and collaborative between providers and patients.

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Summary from NY Times: The health care system squanders $750 billion a year, 30 cents of every medical dollar, through unneeded care, byzantine paperwork, fraud and other waste.  Controlling health care costs is one of the keys to reducing the deficit. The report came from an 18-member panel of experts, including doctors, business people and public officials.


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New iPhone app can detect atrial fibrillation

New iPhone app can detect atrial fibrillation | 1- E-HEALTH by PHARMAGEEK - E SANTE par PHARMAGEEK | Scoop.it

Take Home: UMass Medical School and WPI have developed an app that can detect atrial fibrillation.  This moves connected and mobile health closer to reality.  The really important development with this approch might allow us to treat patients who have AF intermittently (paroxysmal) differently than we currently do.  Because we are worried about stroke, patietns now get blood thinners all the time because we are concerned that they will have recurrences without knowing about it.  With this technology, in the future, we might see validation of a strategy that allows use of blood thinners when patients are in AF only, sometimes called a pill in the pocket.


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FDA Device Surveillance to Tap App

FDA Device Surveillance to Tap App | 1- E-HEALTH by PHARMAGEEK - E SANTE par PHARMAGEEK | Scoop.it
The FDA is creating a largely automated surveillance system to monitor safety of high-risk medical devices, and has authorized a cellphone app for doctors to simplify reporting deaths and injuries to the agency.

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Seth Bilazarian, MD's curator insight, April 24, 2013 4:25 PM

"There's an app for that."  Physicians are often criticized for not doing a better job reporting adverse events and this is largely because the method for reporting to the FDA has been burdensome and difficult. An easy to use reporting strategy from a smartphone will increase my reporting dramatically.  The speed of reporting and analysis by FDA for actionable items should be significantly shortened.

Seth Bilazarian, MD's comment, April 24, 2013 4:27 PM
#app, medical app, #chealth, #mHealth, FDA, adverse event reporting, Bilazarian
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Smartphone images measure up to desktop views in neurology study

Smartphone images measure up to desktop views in neurology study | 1- E-HEALTH by PHARMAGEEK - E SANTE par PHARMAGEEK | Scoop.it

Researchers at the Mayo Clinic have given a boost to telemedicine proponents with the publication of a new study that highlights smartphones' efficacy and quality in capturing medical images to evaluate stroke patients.  The study, published in the September issue of Stroke is the first to test the effectiveness of smartphone teleradiology applications in a real-world telestroke network, according to Mayo Clinic officials.


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Your Car as Your Doctor

Your Car as Your Doctor | 1- E-HEALTH by PHARMAGEEK - E SANTE par PHARMAGEEK | Scoop.it

Ford is developing a car seat capable of monitoring drivers’ ECG to provide real-time health information and alerts of imminent cardiovascular issues such as a heart attack or arrhythmias.

My comment=> The technology is evolving rapidly.  How this will compete with or integrate with mobile devices and wearable monitoring devices remains to be seen.  The auto industry has had reasonable commercial success integrateing technology for entertainement purposes and also new safety technologies.  This health monitoring approach seems like a commercial gimmick, but might help sell cars.  i can envision the marketing of the speeding car with tachometer and heart rate monitor displayed side by side.


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