Last Monday, I was seeing patients at an endocrinologist’s office and he asked us if we could see one more patient before we left. This patient was a 38 y/o African American female who had had diabetes for 3 years. Her last A1c was 6.2 but her glucose readings were all over 150 mg/dl which did not make sense. I asked the endo for an explanation and he let me know that she had sickle cell traits. He provided my intern, Natasha Patel, with a journal article and she decided to put together a paper. Since there are over 1 million diabetes patients with the sickle cell variant I thought that we should share this with you, so please check out Hemoglobinopathies May Distort HbA1C – A Caution to Practitioners for more information.
We are coming to a time when ACOs, both Pioneer and Standard, have to evaluate what has happened over the past few years and decide how they will continue to participate. This week, Most Pioneer ACOs improved Quality Yet Less than Half Lowered Costs, will help you see how some have fared and what their choices might be.
Dave Joffe, Editor-in-chief