Welcome to this month's issue of ACP DiabetesMonthly, an update for internists published by the American College of Physicians.
In the News for the month of March 2014
FDA finds no link between incretin-based drugs, pancreatic complications
Data do not support a causal association between incretin-based drugs and pancreatitis or pancreatic cancer, concluded a review by U.S. and European regulatory agencies. More...
Sulfonylurea as second-line therapy appeared to lower cost in a population-based model
Sulfonylurea as second-line therapy for glycemic control in type 2 diabetes appeared to yield similar outcomes and quality-adjusted life-years but led to lower costs and longer time to insulin dependence compared with a dipeptidyl peptidase-4 inhibitor, glucagon-like peptide-1 receptor agonist, and insulin, according to a recent study. More...
Elderly patients most likely to land in ED, get admitted for insulin-related hypoglycemia
Elderly patients are more likely than younger patients to land in the ED and be hospitalized for insulin-related hypoglycemia and errors, a new study found. More...
MKSAP quiz: Nocturnal hypoglycemia in type 1 diabetes
This month's quiz asks readers to evaluate a 21-year-old man with type 1 diabetes being seen in the office for a follow-up to a recent hospitalization. More...
From ACP InternistWeekly
Standard blood glucose targets are lower than HbA1c goals require
A recent study determined the pre- and postprandial blood glucose levels that should be targeted to reach a specific HbA1c goal in patients with type 1 or type 2 diabetes. More...
From ACP Journal Club
Review: In type 1 or type 2 diabetes, group medical visits improve HbA1c levels compared with usual care
A meta-analysis of 13 randomized, controlled trials of adults with type 1 or type 2 diabetes found that group medical visits improved HbA1c levels but not the other factors studied, which included blood pressure, body mass index, weight, cholesterol, triglycerides, and quality of life. More...
New drug approved, meters recalled
Dapaglifozin (Farxiga), a new medication to treat type 2 diabetes, was recently approved by the FDA for use along with diet and exercise. More...
Spotlight on stroke risk
The effect of hyperglycemia on stroke risk was examined by several studies published in the past month. More...
Editorial note: ACP DiabetesMonthly will not be published next month due to Internal Medicine 2014, which will be held April 10-12.
Physician editor: David V. O'Dell, MD, FACP
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A 76-year-old woman is evaluated for a 3-month history of left knee pain of moderate intensity that worsens with ambulation. She reports minimal pain at rest and no nocturnal pain. There are no clicking or locking symptoms. She has tried naproxen and ibuprofen but developed dyspepsia; acetaminophen provides mild to moderate relief. The patient has hypertension, hypercholesterolemia, and chronic stable angina. Medications are lisinopril, metoprolol, simvastatin, low-dose aspirin, and nitroglycerin as needed. Following a physical exam, lab results and radiograph, what is the next best step in management?
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