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Clinical Topics


Endocrinology

VA Finds Diets Allowing More Fat Might Reduce Diabetes, Other Ailments

For 30 years, Americans have focused on reducing fat to lower their risk of diabetes and other chronic diseases.

Endocrinology

Telemedicine Allows Army, Indian Health Service to Expand Range of Diabetes Care

To reach the growing number of individuals in their care who have diabetes, both the Army and the Indian Health Service have aggressively adopted telemedicine

Endocrinology

Diabetes Overtreatment Continues for Older VA Patients

Some Clinicians Worry More About Malpractice Than HypoglycemiaBy Brenda L. MooneyANN ARBOR, MI — Despite a VA campaign to raise awareness of hypoglycemia and recommendations from the national Choosing Wisely campaign to less aggressively treat... View Article

Endocrinology

‘Yuck Factor’ Notwithstanding, Maggots Highly Effective for Diabetic Foot Wounds at VA

The VA is proving that “everything old is new again” with an unusual medical device — medicinal maggots.

Endocrinology

A Personalized Approach Works Best in Prevention of Diabetes Development

For years, researchers have promoted the wonders of medical treatment customized to a patient’s specific genetic profile, but the reality in the exam room continues to be more “one size fits all.”

Endocrinology

New Veteran Study Further Complicates Testosterone Replacement Issue

VA Researchers Find Normalizing ‘T’ Levels Lowers Heart RisksBy Brenda L. MooneyKANSAS CITY, MO — The question over how testosterone replacement therapy (TRT) affects cardiovascular health became even more contentious with a new U.S. veterans... View Article

Endocrinology

Moderate A1c Reduction Lowers Heart Risks for Veterans With Diabetes

VA Researchers Warn About Too ‘Tight’ Blood-Sugar ControlBy Brenda L. MooneyANN ARBOR, MI — The VA’s balanced approach to glycemic control — keeping blood sugar levels low but not too low — appears to be... View Article

Endocrinology

VA Educates Patients about Who Really Needs Testosterone Therapy

COLUMBIA, MO - Often spurred by advertising touting the benefits of testosterone supplementation for “low T,” veterans treated by the VA increasingly are requesting the replacement therapy.

Endocrinology

Native Americans, Alaskans More Likely to Have Higher HbA1c Levels

OAKLAND, CA – American Indians and Alaska Natives (AI/AN) are more than twice as likely to have diabetes as non-Hispanic Caucasians, and the prevalence of diabetes in the AI/AN populations has increased by more than... View Article

Endocrinology

‘Precision Medicine’ Approach Helps Predict Who Will Develop Diabetes

ANN ARBOR, MI – A new “precision medicine” approach to diabetes prevention uses existing information such as blood sugar levels and waist-to-hip ratios, rather than a genetic test, to determine who has the highest risk... View Article

Endocrinology

Black Women Working the Night Shift More Likely to Develop Diabetes

BEDFORD, MA – African-American women who work night shifts are significantly more likely to develop diabetes, and their risk increases the longer they work that schedule. That’s according to a new study published in Diabetolgia,... View Article

Endocrinology

Veteran Study Shows Significant Survival Benefit From Bariatric Surgery

DURHAM, NC - While evidence is growing that bariatric surgery can improve survival among the severely obese, past research hasn’t been as useful for some of the patients who would benefit most from weight loss.

Endocrinology

VA Tackles Obesity Paradox:

Why Do Overweight Patients Live Longer with Heart Failure? Now the leading cause of hospital admissions in the VA Health Care System, heart failure is associated with high mortality rates and poor quality of life.

Endocrinology

New VA Initiative Battles Excesses of ‘Tight Glucose Control’ Trend

Effort Seeks to Reduce Hypoglycemia in Older Veterans WASHINGTON - At the beginning of the 21st century, tight glucose control for patients with type 2 diabetes was all the rage.

Endocrinology

Test Strip Overuse Common with Dual Benefits

PITTSBURGH – Veterans who double dip benefits, receiving glucose test strips through both the VA and Medicare, use more strips and are more likely to potentially overuse the measurement devices, according to a new study.... View Article

Endocrinology

Insomnia Doubles Risk of Chronic Diseases in Servicemembers

BETHESDA, MD – Chronic insomnia doubles the risk of developing hypertension and type 2 diabetes in servicemembers compared to military personnel who have not been diagnosed with that sleep problem. That’s according to a report... View Article

Endocrinology

Mindfulness Training Helps Vets with Diabetes

PITTSBURGH – Veterans who participated in mindfulness training lowered their diabetes-related distress and glucose levels while improving their self-management of the disease, according to a new study. The training included focused breathing and awareness training,... View Article

Endocrinology

With More Women in Military, the ‘Great Imitator’ Often Challenges Health Providers

Lupus Diagnoses Have Risen Significantly BETHESDA, MD - As the fictional team of physicians attempted to identify mysterious conditions season after season, TV’s Dr. Gregory House often assured them, “It’s not lupus — It’s never lupus.” But in recent years, many DoD physicians have found that it is lupus — it’s increasingly lupus.

Endocrinology

November 2014 Direct

NOVEMBER ISSUE Forward this newsletter to a colleague U.S. MEDICINE NEWS UPDATE VA Secretary Defends Actions to Hold Individuals Accountable WASHINGTON – VA is moving as “aggressively and expeditiously as possible by the law” in... View Article

Endocrinology

New Weight Management Treatment Approved

PLAINSBORO, NJ – The Food and Drug Administration has approved a new treatment option for chronic weight management in addition to a reduced-calorie diet and physical activity. Saxenda (liraglutide [rDNA origin] injection) is approved for... View Article

Endocrinology

Healthcare Providers Should Consider Ethnicity in Weight-Loss Counseling

Studies Show Unique Needs of Hispanic, Veteran Populations By Annette M. Boyle NEW YORK – Since 2003, the proportion of new military recruits who identified as Hispanic has increased by more than 50% and the... View Article

Endocrinology

Air Force Program Helps Prediabetic Patients Battle the Bulge

SAN ANTONIO - For many veterans, leaving the service marks the beginning of a new battle — the constant fight against obesity. Sudden weight gain often accompanies the transition to civilian life, with more than 70% of veterans ending up overweight and at elevated risk of developing diabetes and a complex cascade of related health issues.

Endocrinology

Danger of Pneumonia Increases with Veterans’ Worsened Health Status

Higher Pneumonia Vaccine Rates Urged By Brenda L. Mooney PROVIDENCE, RI – With influenza season each year comes an even greater challenge for VA hospitals — a spate of pneumonia cases in older veterans. Recent... View Article

Endocrinology

Researcher Who Transformed Spinal Cord Injury Care Gets Coveted Award

BRONX, NY - Spinal cord injuries have far more effect than limiting movement, and the vision of William A. Bauman, MD, has transformed the lives of countless patients who have the devastating condition.

Endocrinology

First Metformin, SGLT2 Combination Approved by FDA

RARITAN, NJ – The Food and Drug Administration has approved the first fixed-dose combination of a sodium glucose cotransporter 2 (SGLT2) inhibitor and metformin for use in the United States. The drug, Invokamet, is marketed... View Article

Endocrinology

Evolution of Pioneer DCVAMC Clinic Tracks AIDS/HIV Treatment Through the Years

By Stephen Spotswood WASHINGTON – When the first Infectious Disease Clinic took place at the Washington, DC, VAMC in 1985, only a handful of HIV-infected patients took advantage. In fact, the disease hadn’t even been... View Article

Endocrinology

VA’s Home-Based Care Program Reduces Hospitalization for Diabetes, Other Conditions

By Brenda L. Mooney BOSTON – When it comes to providing care to older patients with co-existing diabetes and other chronic illnesses, everything old is new again at the VA. A program offering old-fashioned house calls... View Article

Endocrinology

Discharge to Deployment: Military Diabetes Management Changes Over 50 Years

By Annette M. Boyle WASHINGTON – In 1964, a diagnosis of diabetes led to immediate discharge from the Army. Today, soldiers with well-managed diabetes can continue to have long and successful military careers. “With the... View Article

Endocrinology

August 2014 Focus

In this Issue: Focus on Infectious Diseases HIV/HCV Co-Infected Patients Have No Safe Level of Alcohol Use VA’s Resistant Infection ‘Bundle’ Drives Down MRSA in Community Living Centers Pharmacy Update Milwaukee VA Develops Reversal Protocol... View Article

Endocrinology

August 2014 Direct

AUGUST ISSUE Forward this newsletter to a colleague U.S. MEDICINE NEWS UPDATE Christianne L. Roumie, MD, MPH VA Studies Raise Key Issues about Trends in Type 2 Diabetes Treatment NASHVILLE – New VA research soon... View Article

Endocrinology

April 2014 Focus

In this Issue: News Update Intensive BP-Lowering Didn’t Affect Cognitive Function in Diabetes Focus on Men’s Health New Study: Are ‘Low T’ Guidelines Followed in VA? Prostate Cancer Recurrence Risk Rises 50% with Elevated Glucose... View Article

Endocrinology

VA Studies Raise Key Issues about Trends in Type 2 Diabetes Treatment

Early Insulin, Singular Focus on HbA1c Not Always Best By Brenda L. Mooney NASHVILLE — New VA research soon might change the way clinicians treat veterans with type 2 diabetes. Despite the increased push for... View Article

Endocrinology

Less Diabetes Control in Non-adherence HIV Patients

DURHAM, NC – Poor adherence to antiretroviral therapy in veterans with human immunodeficiency virus (HIV) also is a good predictor of whether those same patients will achieve good control if they have diabetes. That’s according... View Article

Endocrinology

Diagnosis Prompts Weight Loss Efforts in Short Term

DURHAM, NC – Patients may rush to start a weight loss program upon diagnosis of an obesity-related disease but often are unable to sustain the effort on that basis alone, according to a new VA... View Article

Endocrinology

Surgery Means Better Glucose Control for Veterans

BRONX, NY – Laparoscopic sleeve gastrectomy produced better blood glucose control for veterans after two years than standard diabetes medical care without weight loss surgery, according to a new study. The research, presented recently at... View Article

Endocrinology

TBI Increases Dementia Risks for Older Veterans

MINNEAPOLIS – Experiencing a traumatic brain injury (TBI) ups the risk 60% for older veterans to later develop dementia, according to a recent study. The report, published recently in the journal Neurology, also found that,... View Article

Endocrinology

Stroke Kills Young American Indian/Alaska Natives at Twice Rate of Whites

By Annette M. Boyle ATLANTA – While three-quarters of stroke patients are older than 65, a “brain attack” can affect people of any age. For young American Indians and Alaskan Natives (AI/AN), that information is... View Article

Endocrinology

TRICARE Limits on Use of Community Pharmacies Creates Firestorm

By Annette M. Boyle ALEXANDRIA, VA – A pilot program that requires use of mail order or military pharmacies for certain maintenance medications taken for chronic conditions has sparked a firestorm of controversy, upsetting community... View Article

Endocrinology

2014 Compendium of Federal Medicine Introduction

Until my father enlisted in the U.S. Army in 1942, he lived in Brooklyn, NY. That changed after serving honorably in Europe during World War II. As soon as he disembarked from the troop ship, he telephoned a woman he met while in training at Camp (now Fort) Stewart, GA. Within hours, he was hitchhiking to Vidalia, GA, to propose marriage to the woman, who became his wife and the mother of my two sisters and me.

Endocrinology

Army Turns to NCOs to Combat Obesity, Related Issues, in Soldiers

While the vast majority of soldiers maintain healthy weights, bad habits developed during deployment and on military bases follow them after retiring from the Army. In fact, more than 70% of veterans end up overweight.... View Article

Endocrinology

New Biomarkers May Be More Accurate than HbA1c in Diabetes Screening

Although widely used to monitor glucose control and — more recently — to diagnose diabetes, HbA1c screening lacks accuracy in a range of patients with hemoglobinopathies, kidney issues or HIV. A new study, supported by... View Article

Endocrinology

February 2014 Focus

In this Issue: News Update DNA Used to Predict Amputee’s Pain Levels Focus on Cardiology VA, Army Clinicians Rapidly Increase Prescribing of Novel Anticoagulants Female Veterans Develop CVD Risk Factors at Younger Ages Pharmacy Update... View Article

Endocrinology

January 2014 Focus

In this Issue: News Update Army Announces Warrior Transition Unit Changes Focus on Obesity Leaner Fighting Forces Might Mean Slim Pickings for Recruiters New Formulary Drugs Promote Weight Loss, Reduce Diabetes Pharmacy Update Pharmacist Monitoring... View Article

Endocrinology

Spirometry Touted as Best Way to Accurately Diagnose COPD

Test Results Also Valuable in Inspiring Smoking Cessation SEATTLE — Spirometry remains the only recognized method of definitively diagnosing chronic obstructive pulmonary disease, but nearly two-thirds of patients with a COPD diagnosis have never had... View Article

Endocrinology

Prescriptions for ‘Low T’ Therapy Vary Substantially Across VHA

Study Questions Whether Guidelines Are Being Followed By Annette M. Boyle EAST ORANGE, NJ — Across the VHA, more than 85,000 men receive testosterone supplementation therapy. The likelihood that any particular patient would be prescribed... View Article

Endocrinology

Prostate Cancer Recurrence Risk Rises 50% with Elevated Glucose Levels

By Annette M. Boyle SEATTLE — Obesity is clearly associated with poor outcomes in patients with prostate cancer, according to past research, but the reason why has remained elusive. Now a new study suggests the... View Article

Endocrinology

Black Servicemembers At More Hypertension Risk, Despite Equitable Healthcare

SILVER SPRING, MD — Military research is raising a new question about an old issue: Why do African-Americans have higher incidence rates of hypertension compared with servicemembers of other races and ethnicities despite equitable access to healthcare within the armed forces?

Endocrinology

Meeting Two Treatment Goals Significantly Reduces CVD Risk

NEW ORLEANS — Veterans with diabetes who met treatment goals for both HbA1c and LDL cholesterol significantly reduced their risk for microvascular complications, acute coronary syndromes, percutaneous coronary intervention and coronary artery bypass graft compared... View Article

Endocrinology

Group Appointments Improved Dyslipidemia in Diabetic Vets

DURHAM, NC — How effective are group medical appointments for improving dyslipidemia in veterans with uncontrolled diabetes and hypertension? A recent study led by researchers from the Center for Health Services Research in Primary Care... View Article

Endocrinology

Intensive BP-Lowering Didn’t Affect Cognitive Function in Diabetes

WINSTON-SALEM, NC — A decline in cognitive function, reduced brain volume and increased white matter lesions are all risks for patients with type 2 diabetes mellitus (T2DM), especially with high blood pressure and lipid levels.... View Article

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