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Monthly Archives: March 2016

A1C Preference

If you could have any A1c result regardless of your health, even if you don’t have diabetes, what A1c number would you like to have? Follow the link to respond and see what others think.

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Question 826

Test Your Knowledge

Mr. Carlson is a 52-year-old Caucasian grocery store manager you saw last week for a new patient visit. His labs from that visit were significant for elevated random plasma glucose 166 mg/dL, A1C 7.4% and elevated lipids (TG=175 mg/dL, LDL 148 mg/dL, HDL 38 mg/dL, total cholesterol 221 mg/dL). He has returned to your clinic for a follow-up appointment. His physical exam is notable for central abdominal obesity (waist circumference 42”), left eyelid xanthelasma, BP 147/91, HR 72, RR 18, BMI 36 kg/m2, but otherwise normal. A repeat A1C test shows A1C 7.6%. Mr. Carlson smokes between 1 and 1.5 packs of cigarettes daily. After discussing the labs and your findings with Mr. Carlson, you begin collaborating on a management plan. You write prescriptions for metformin, a statin and ACE inhibitor. Mr. Carlson doesn’t think “taking medication will be too tough,” but expresses skepticism about your recommendations for a change in his diet, exercise and smoking programs because he has tried them, without success, in the past. What is considered the starting BMI for consideration of bariatric surgery? Select one answer: A. BMI greater than 28 kg/m2 B. BMI greater than 30 kg/m2 C. BMI greater than 35 kg/m2 D. BMI greater than 37 kg/m2 Are you right? Follow the link to find out!

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Halo Pronto™

The Doc Halo Mobile Health Platform is the leading clinical communication system for healthcare. The mobile app and online console provide secure, HIPAA-compliant texting for the safe transmission of protected patient information.

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For over a year now we have had one of the premier hypertensive care physicians sharing his opinions and information on the treatment of hypertension. This week, Dr. George Bakris starts a new video series on hypertensive guidelines and how best to use them for patients. These choices become more …

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The New To-Do For Travel

A patient with diabetes gets her meds, prescribed by a nurse practitioner, from a national chain pharmacy in New York. She was planning travel to Hawaii. Patient did not refill her meds at home in New York before leaving for her travel in Hawaii because it was too early. Insurance would not pay until closer to the refill date. She thought she could wait until the time insurance would cover, go to a location where she was traveling and pick it up there. She’d done that during her travels in the past. It did not work in Hawaii.

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International Textbook of Diabetes Mellitus, 4th Ed., Excerpt #16: Epidemiology and Geography of Type 2 Diabetes Mellitus Part 5 of 5

Obesity and weight gain have consistently been shown to be the one of the strongest modifiable risk factors for diabetes. The ratio of a person’s weight in kilograms divided by the square of their height in meters called the body mass index (BMI) has been used in numerous studies as a surrogate for obesity. In a representative sample of the US population, each unit increase in BMI was associated with a 12% increased risk of T2DM. Compared to people with BMI less than 22 kg/m2 those with BMI of 25–27 kg/m2 had 2.75 times the risk of diabetes, and each kilogram increase in body weight over 10 years was associated with a 4.5% increase in diabetes risk.

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