Early adoption of insulin therapy for diabetes can stop or delay progression of the disease and help avoid complications. But change has been slow, even at VA, where more than a million veterans get treatment for the disease. A VA pharmacist offers advice to clinicians on how to initiate earlier insulin treatment.

Prevention Is the Goal
During the past three years, the VA has more than doubled the number of veterans in care who have been tested for HIV and linked those who are positive to HIV specialists. Newer programs focus on preventing transmission through aggressive treatment and prophylaxis, with mixed results.

Controversy continues about when and for whom prostate-specific antigen (PSA) screening makes sense. PSA testing often is on lists of “excessive” medical procedures, but primary-care physicians are uncomfortable doing no screening for the common cancer. Two VA clinicians who have researched extensively in the area offer practical advice.

A project to measure performance and improve inpatient stroke care at the VA has shown considerable success. Now, the focus has shifted to post-stroke care and the outpatient arena.

From diagnosis to selecting therapeutics to predicting the course of the disease, everything about treating multiple sclerosis is complex. New research revealing that male MS patients are likely to suffer other chronic diseases such as hypertension, diabetes and coronary artery disease only makes management of the disease more difficult. The VA offers some tools to help clinicians navigate.