KevinMD.com: Social media’s leading physician voice
The KevinMD newsletterReal physician voices, twice a weekFree, and one click to unsubscribe.
Subscribe free →

Diabetes care

452 articles · Since 2004

Articles, page 8

Physician voices

The sad direction of hospital care

13

My 74-year old obese, poorly controlled diabetic patient with high blood pressure, high cholesterol, coronary artery disease, asthma, obstructive sleep apnea has been difficult to motivate to improve his lifestyle and his health. He is bright, sweet and caring but…

My 74-year old obese, poorly controlled diabetic patient with high blood pressure, high cholesterol, coronary artery disease, asthma, obstructive sleep apnea has been difficult to motivate to improve his lifestyle and his health. He is bright, sweet and caring but just not very disciplined.

At each office visit, we review his medications, review his dietary habits and go through the check list of check-ups for diabetic complications including regular ophthalmology exams …

Read more…

The sad direction of hospital care

Health technology

Artificial intelligence in health care: Better studies are needed

An article in Newsweek magazine says, “Artificial intelligence will cure America’s sick health care system” using data and automation to “drive down the costs of health care while increasing effectiveness.” According to Newsweek, it will work like this for diabetes.…

An article in Newsweek magazine says, “Artificial intelligence will cure America’s sick health care system” using data and automation to “drive down the costs of health care while increasing effectiveness.”

According to Newsweek, it will work like this for diabetes. A company called Virta Health has come up with a smartphone app that is like “a live-in doctor and diabetes coach.” Type 2 diabetics who enroll will enter data such as blood sugar …

Read more…

Artificial intelligence in health care: Better studies are needed

Conditions and diseases

MKSAP: 25-year-old woman with type 1 diabetes

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 25-year-old woman with type 1 diabetes presents to clinic requesting more information about use of a closed-loop insulin-delivery system (artificial beta cell). Although…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 25-year-old woman with type 1 diabetes presents to clinic requesting more information about use of a closed-loop insulin-delivery system (artificial beta cell).

Although her HbA1c is at goal, she notes frequent hypoglycemia as an issue. In addition, she would like to further improve her glycemic control in anticipation of pregnancy in the next …

Read more…

MKSAP: 25-year-old woman with type 1 diabetes

Real physician voices, twice a week

Free, and one click to unsubscribe.

No spam. We never share your email.

Social media in medicine

A diabetes forum tried to lock down photo sharing. Twitter wasn’t happy.

Attendees at the American Diabetes Association’s Scientific Sessions in San Diego this year — many of them young researchers who are active on social media — were surprised to be greeted with the following: “Thanks for joining us at #2017ADA!…

Attendees at the American Diabetes Association’s Scientific Sessions in San Diego this year — many of them young researchers who are active on social media — were surprised to be greeted with the following: “Thanks for joining us at #2017ADA! Photography isn’t allowed during presentations — we’d appreciate it if you’d delete this tweet.”

For many, the essence of gathering at conferences is the sharing of scientific information, a peek at …

Read more…

A diabetes forum tried to lock down photo sharing. Twitter wasn’t happy.

Conditions and diseases

MKSAP: 56-year-old woman with type 2 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 56-year-old woman presents to the office to discuss management of her type 2 diabetes mellitus. She is unhappy with her recent HbA1c value.…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 56-year-old woman presents to the office to discuss management of her type 2 diabetes mellitus. She is unhappy with her recent HbA1c value. She adheres to the maximum dose metformin monotherapy, which she has been taking for 1 year. Additionally, she has been working toward weight reduction without success; however, weight …

Read more…

MKSAP: 56-year-old woman with type 2 diabetes mellitus

Conditions and diseases

How a mathematician developed an algorithm to help treat diabetes

When people ask me why I, an applied mathematician, study diabetes, I tell them that I am motivated for both scientific and human reasons. Type 2 diabetes runs in my family. My grandfather died of complications related to the condition.…

When people ask me why I, an applied mathematician, study diabetes, I tell them that I am motivated for both scientific and human reasons. The Conversation

Type 2 diabetes runs in my family. My grandfather died of complications related to the condition. My mother was diagnosed with the disease when I was 10 years old, and my Aunt Zacharoula suffered from it. I myself am pre-diabetic.

As …

Read more…

How a mathematician developed an algorithm to help treat diabetes

Conditions and diseases

MKSAP: 74-year-old woman with altered mental status

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 74-year-old woman is evaluated in the emergency department for several hours of altered mental status. She is from out-of-state and is visiting with…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 74-year-old woman is evaluated in the emergency department for several hours of altered mental status. She is from out-of-state and is visiting with relatives. One of her young relatives was recently ill with gastrointestinal symptoms. The patient developed anorexia 3 days ago and vomiting 2 days ago. She has been unable to …

Read more…

MKSAP: 74-year-old woman with altered mental status

Conditions and diseases

MKSAP: 68-year-old man with a right intertrochanteric fracture

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is evaluated in the hospital for a right intertrochanteric fracture sustained in a mechanical fall. He reports right hip pain but…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 68-year-old man is evaluated in the hospital for a right intertrochanteric fracture sustained in a mechanical fall. He reports right hip pain but no other symptoms. He has hypertension and type 2 diabetes mellitus and was in his usual state of health prior to the fall. He checks his blood glucose level several times …

Read more…

MKSAP: 68-year-old man with a right intertrochanteric fracture

Conditions and diseases

MKSAP: 40-year-old man with type 1 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 40-year-old man with type 1 diabetes mellitus presents to the office. He seeks advice on his diabetes management as he intensifies his exercise…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 40-year-old man with type 1 diabetes mellitus presents to the office. He seeks advice on his diabetes management as he intensifies his exercise routine in preparation for participation in a 10-K race. He reports prolonged hypoglycemia during intense exercise, despite eating a meal prior to the activity. His insulin regimen is insulin …

Read more…

MKSAP: 40-year-old man with type 1 diabetes mellitus

Conditions and diseases

MKSAP: 21-year-old woman with type 1 diabetes

A 21-year-old woman is evaluated for management of type 1 diabetes. She was diagnosed 3 months ago after presenting to the emergency department with diabetic ketoacidosis. Her HbA1c level at the time of diagnosis was 15.2%. She was discharged from…

A 21-year-old woman is evaluated for management of type 1 diabetes. She was diagnosed 3 months ago after presenting to the emergency department with diabetic ketoacidosis. Her HbA1c level at the time of diagnosis was 15.2%. She was discharged from the hospital on a basal and prandial insulin regimen with minor adjustments required as an outpatient. Her blood glucose log demonstrates a recent change manifesting as frequent symptomatic episodes of …

Read more…

MKSAP: 21-year-old woman with type 1 diabetes

Conditions and diseases

MKSAP: 51-year-old man with newly diagnosed hypertension and diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 51-year-old man is evaluated during a follow-up visit for management of newly diagnosed hypertension and diabetes mellitus. He has started a program of…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 51-year-old man is evaluated during a follow-up visit for management of newly diagnosed hypertension and diabetes mellitus. He has started a program of lifestyle modification for his diabetes but has not yet started antihypertensive therapy. He is currently taking no medications.

On physical examination, blood pressure is 148/92 mm Hg, and pulse rate …

Read more…

MKSAP: 51-year-old man with newly diagnosed hypertension and diabetes mellitus

Drugs and prescribing

A medicine for poor people

15

Last week I had an appointment with one of my well-controlled diabetics. She has been in my care for the last six years. Our usual cheery interaction turned sour when she stated in an accusing tone, “My husband is diabetic,…

Last week I had an appointment with one of my well-controlled diabetics.  She has been in my care for the last six years.   Our usual cheery interaction turned sour when she stated in an accusing tone, “My husband is diabetic, and I talked to his doctor about the medication you have me on.  He says it is junk, and he only writes it for poor people, and he doesn’t understand …

Read more…

A medicine for poor people

Conditions and diseases

MKSAP: 57-year-old man with substernal chest pain

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man is admitted to the hospital for evaluation of substernal chest pain. His medical history is significant for type 2 diabetes mellitus,…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 57-year-old man is admitted to the hospital for evaluation of substernal chest pain. His medical history is significant for type 2 diabetes mellitus, coronary artery disease, hypertension, and hyperlipidemia. He manages his diabetes as an outpatient with diet, exercise, and metformin. His other medications are aspirin, metoprolol, atorvastatin, and sublingual nitroglycerin as …

Read more…

MKSAP: 57-year-old man with substernal chest pain

Conditions and diseases

MKSAP: 66-year-old man with polyuria and polydipsia

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 66-year-old man is evaluated in the office after being treated in the emergency department for an exacerbation of chronic obstructive pulmonary disease. While…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 66-year-old man is evaluated in the office after being treated in the emergency department for an exacerbation of chronic obstructive pulmonary disease. While in the emergency department, he was noted to have a random blood glucose level of 211 mg/dL (11.7 mmol/L). His HbA1c was 7.8% at the time. A repeat random …

Read more…

MKSAP: 66-year-old man with polyuria and polydipsia

Conditions and diseases

MKSAP: 52-year-old woman with type 2 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman presents for follow-up evaluation after being diagnosed with type 2 diabetes mellitus 6 weeks ago. Her initial HbA1c level was 8.0%.…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 52-year-old woman presents for follow-up evaluation after being diagnosed with type 2 diabetes mellitus 6 weeks ago. Her initial HbA1c level was 8.0%. Management at this time is with lifestyle modifications. She has worked closely with a diabetes educator and a nutritionist since her diagnosis. She has lost 3.2 kg (7 lb) …

Read more…

MKSAP: 52-year-old woman with type 2 diabetes mellitus

Drugs and prescribing

What’s behind the rising cost of insulin?

11

She drew the life-saving medication into the syringe, just 10 cc of colorless fluid for the everyday low price of, gulp, several hundred dollars. Was that a new chemotherapy, specially designed for her tumor? Was it a “specialty drug,” to…

She drew the life-saving medication into the syringe, just 10 cc of colorless fluid for the everyday low price of, gulp, several hundred dollars. Was that a new chemotherapy, specially designed for her tumor? Was it a “specialty drug,” to treat her multiple sclerosis? Nope. It was insulin, a drug that has been around for decades.

The price of many drugs has been on the rise of late, not just new …

Read more…

What’s behind the rising cost of insulin?

Conditions and diseases

MKSAP: 44-year-old man with type 2 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 44-year-old man is evaluated for management of type 2 diabetes mellitus. He was diagnosed with diabetes 6 months ago after being admitted to…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 44-year-old man is evaluated for management of type 2 diabetes mellitus. He was diagnosed with diabetes 6 months ago after being admitted to the hospital with diabetic ketoacidosis. He was discharged from the hospital on a basal and preprandial insulin regimen. Medications are regular insulin before meals and neutral protamine Hagedorn (NPH) …

Read more…

MKSAP: 44-year-old man with type 2 diabetes mellitus

Health technology

Insurance companies cannot dictate which medical devices we prescribe

6

The diabetes community has been set ablaze after UnitedHealthcare announced an agreement for Medtronic devices to be the “preferred” in-network, durable medical equipment (DME) provider of insulin pumps. Starting July 1, 2016, UnitedHealthcare patients will be funneled toward using a…

The diabetes community has been set ablaze after UnitedHealthcare announced an agreement for Medtronic devices to be the “preferred” in-network, durable medical equipment (DME) provider of insulin pumps. Starting July 1, 2016, UnitedHealthcare patients will be funneled toward using a Medtronic insulin pump instead of offerings from manufacturers like Tandem and Animas.

Many diabetes advocates have eloquently voiced their outrage …

Read more…

Insurance companies cannot dictate which medical devices we prescribe

Conditions and diseases

MKSAP: 55-year-old man is evaluated following a screening for type 2 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated following a screening for type 2 diabetes mellitus. He is asymptomatic. He has a history of hypertension and hyperlipidemia.…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 55-year-old man is evaluated following a screening for type 2 diabetes mellitus. He is asymptomatic. He has a history of hypertension and hyperlipidemia. There is no history of anemia, liver disease, or kidney disease. Medications are lisinopril and rosuvastatin.

On physical examination, blood pressure is 123/76 mm Hg and pulse rate is 72/min. …

Read more…

MKSAP: 55-year-old man is evaluated following a screening for type 2 diabetes mellitus

Conditions and diseases

MKSAP: 48-year-old woman with type 1 diabetes mellitus

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 48-year-old woman returns for a follow-up visit for management of type 1 diabetes mellitus. She reports doing well since the last visit. Overall,…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 48-year-old woman returns for a follow-up visit for management of type 1 diabetes mellitus. She reports doing well since the last visit. Overall, she believes that most of her blood glucose levels are at goal, but is concerned about occasional episodes of hyperglycemia occurring in the morning before breakfast. She eats a bedtime snack …

Read more…

MKSAP: 48-year-old woman with type 1 diabetes mellitus

13
pages