New survey highlights difference in health priorities between diabetics, doctors
ANN ARBOR, Mich. A new survey conducted by the University of Michigan Medical School revealed that diabetes patients and their doctors do not necessarily see eye-to-eye when it comes to health concerns.
Researchers at U-M and Veterans Affairs surveyed 92 doctors and their nearly 1,200 patients who had diabetes and hypertension. Of the 714 pairs, 28% did not prioritize health conditions the same way. The disparity was strongest among the sickest patients, the researchers said.
Despite the fact that both patients and doctors named diabetes and hypertension their biggest concerns, 38% of doctors were more likely to rank hypertension as the most important, while only 18% of diabetics said it was the most important. Patients also were more likely to consider such symptoms as pain and depression to be relevant to their condition.
The findings appear in the current issue of the Journal of General Internal Medicine.
“If a patient and their doctor do not agree on which of these issues should be prioritized, it will be difficult for them to come up with an effective treatment plan together,” said lead author Donna M. Zulman, M.D., a Robert Wood Johnson Clinical Scholar at the University of Michigan Medical School and researcher at the Veterans Affairs Healthcare System in Ann Arbor.
‘Silent strokes’ linked to kidney failure in diabetics
WASHINGTON Tiny areas of brain damage caused by injury to small blood vessels can signal an increased risk of kidney disease and kidney failure, according to a new study by Japanese researchers.
Publishing in the Journal of the American Society of Nephrology, researchers led by Takashi Uzu of the Shiga University School of Medicine in Otsu, Japan, included 608 patients with Type 2 diabetes, all initially free of symptomatic stroke, heart disease or kidney disease.
Using magnetic resonance imaging scans of the brain, the researchers found that 29% of the patients had the small areas of brain damage, known as silent cerebral infarction or “silent stroke.” A long-term follow-up of the patients found that those with SCI had higher risks of progressive kidney disease, and compared with those who had normal MRI scans, patients with SCI were about 2.5 times more likely to die or develop end-stage kidney disease.
“Silent cerebral infarction may be a new marker to identify patients who are at risk for declining kidney function,” Uzu said in a statement.
Uzu said that small amounts of the protein albumin present in the urine – a condition known as microalbuminuria – are the most important market to predict the progression of kidney disease in diabetics, but decreased kidney function without microalbuminuria is common in those with Type 2 diabetes. According to the new study, diabetics with SCI were more likely to develop serious kidney disease regardless of the protein condition.
Decision Resources: Spiriva to remain clinical gold standard as COPD treatment
WALTHAM, Mass. A drug from Boehringer Ingelheim and Pfizer will retain Decision Resources’ status as a gold standard of treatment for chronic obstructive pulmonary disease through 2018, according to a report released by the market research firm Tuesday.
While some COPD drugs in development held promise, they lacked the same efficacy, safety and tolerability and delivery features of Spiriva (tiotropium bromide), according to the report, titled “Chronic Obstructive Pulmonary Disease: Opportunity Exists for Combination Therapies that Offer Improved Convenience and Outcomes.”
“Our survey of primary care physicians indicates that a drug’s effect on quality of life improvement is the attribute that most influences PCPs’ prescribing decisions in moderate to very severe chronic obstructive pulmonary disease,” Decision Resources analyst Amy Whiting said.