News From The Annals Of Internal Medicine, Sept. 1, 2009
Gumbo
Main Category: Diabetes
Also Included In: Heart Disease; Nutrition / Diet; Statins
Article Date: 01 Sep 2009 - 3:00 PDT
1. Mediterranean Diet Trumps Low-fat Diet for Diabetes Management Patients
on Low-Carbohydrate Mediterranean Diet Avoided Medication, Lost More Weight,
and Decreased Some Coronary Risk Factors
In one of the longest-term randomized trials of its kind, researchers
compared the effects of a Mediterranean-style diet versus a typical low-fat
diet for diabetes management. The trial was designed to assess the
effectiveness, durability, and safety of the two diets on the need for
diabetes medications in overweight patients with newly-diagnosed type 2
diabetes. Researchers randomly assigned 215 patients to follow either a low
carbohydrate, Mediterranean-style diet or a low-fat diet for four years.
Nutritionists and dietitians counseled both groups in monthly sessions for
the first year and bimonthly sessions for the next three years. After four
years, 44 percent of patients in the Mediterranean-style diet group required
antihyperglycemic drug therapy compared to 70 percent in the low-fat diet
group. Patients in the Mediterranean diet group also experienced greater
weight loss and an improvement in some coronary risk factors.
Note: The above study is the subject of a video news story. Satellite feed
dates, times, and coordinates are below.
2. For Three Common Illnesses, Retail Clinics Provide Quality Care at a
Lower Cost
Health clinics located in retail stores such as pharmacy, discount, or
grocery chains provide a new model for urgent care. These types of clinics
appeal to consumers because they require no appointments, have convenient
hours, and offer diagnosis and treatment of common conditions. However,
concerns exist about the cost, rate of misdiagnosis, overuse of antibiotics,
and decreased delivery of preventive care at these clinics. Researchers
compared the cost and quality of care received at retail clinics for 2,100
patients (700 each) with ear infection, pharyngitis (sore throat), and
urinary tract infection with that received at other care settings in
Minnesota. They found that overall costs of care were substantially lower at
retail clinics than at urgent care centers and emergency departments. In
addition, prescription costs and quality scores were similar to that of
physician offices and urgent care centers. The researchers also found that
patients at retail clinics were as likely to receive preventive care as were
patients who visited other care settings.
3. In an Era of Less Media Scrutiny, John F. Kennedy Hid Serious Health
Problems from the Public
At the age of 43, John F. Kennedy was the youngest man ever elected
president. During his campaign and presidency, the media portrayed him as
the epitome of youth and vigor. However, a recent review of Kennedy's White
House medical records, as well as correspondence from his physicians,
reveals that Kennedy had the most complex medical history of any U.S.
president. Unbeknownst to the public, Kennedy was diagnosed with Addison's
disease, a rare endocrine disorder in which the adrenal glands do not
produce enough of the hormone cortisol. Later, when Kennedy was a senator,
he was found to have hypothyroidism. During the 1960 campaign for the
presidency, Kennedy's physician denied the Addison's diagnosis and deflected
further probes with a carefully-worded statement to the media. Today, with
newly available evidence, researchers can plausibly conclude that Kennedy
had a rare unifying autoimmune endocrine disorder called polyendocrine
syndrome type II, or APS II, which is characterized by the coexistence of
hypothyroidism and Addison's disease, among other conditions.
4. Statin Medication in Combination with another Cholesterol-Lowering Agent
Does Not Improve Clinical Outcomes over High-dose Statin Therapy Alone
More than 28 million Americans have some form of cardiovascular disease.
Physicians commonly prescribe statin therapy to lower LDL cholesterol
levels. Lowering bad cholesterol levels helps to prevent the blockage of an
artery that can lead to heart attack and stroke. However, only one third of
all patients are able to lower their LDL cholesterol to appropriate levels,
and proportionally fewer with established coronary heart disease are able to
do so. For this reason, physicians recognize a critical need to identify
effective treatment strategies for individuals requiring intensive lowering
of cholesterol. Treatment options for these individuals include an increased
dose of statin medication alone or the use of a statin in combination with
another lipid-modifying agent of another class. Ezetimibe, niacin, bile acid
sequestrants, fibrates, and omega-3 fatty acids are available treatment
options for combination with statins. To compare the benefits and risks of
high-dose statin monotherapy with combination statin therapy in adults at
risk for coronary disease, researchers analyzed 102 published studies and
found no benefit of combination therapy for mortality, heart attack, stroke,
and revascularization procedures over high-dose statin therapy alone in
individuals requiring intensive lipid lowering.
Source:
Laura Zansitis
American College of Physicians
Source: http://www.medicalnewstoday.com/articles/162425.php
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