Navigation Links
Patients with diabetes may not receive best treatment to lower heart disease risk

ANN ARBOR, Mich. For some people with diabetes, there may be such a thing as too much care.

Traditional treatment to reduce risks of heart disease among patients with diabetes has focused on lowering all patients' blood cholesterol to a specific, standard level. But this practice may prompt the over-use of high-dose medications for patients who don't need them, according to new research from the VA Ann Arbor Healthcare System (VAAAHS) and the University of Michigan Health System.

The study encourages a more individualized approach to treatment that adjusts treatment according to the patient in order to improve the quality of care. The findings appear in Circulation: Cardiovascular Quality and Outcomes.

Authors also suggest that blanket goals routinely used to lower heart attack risks may unnecessarily expose some patients to potential adverse side effects of high-dose medications. Researchers also note that when these standard goals are used to assess whether a health provider delivered high quality care, they may encourage overly aggressive treatment.

"We want patients to get the treatment they need to prevent heart attacks and cardiovascular issues but we don't want to expose them to additional treatment risks without strong evidence of the benefits," says senior author Eve Kerr, M.D., director of the Center for Clinical Management Research at the VAAAHS, professor of internal medicine at the U-M Medical School and a member of the U-M Institute for Healthcare Policy and Innovation.

"We need to move away from a one-size-fits-all performance measure that misses the point of providing appropriate treatment."

Managing cholesterol is especially important for people with type 2 diabetes who often have an increased risk for a heart attack. This is especially true for people age 50 and over.

Physicians commonly aim to lower blood cholesterol for all patients with diabetes to below 100 mg/dl. Recent evidence, however, highlights the importance of individualized treatment for each patient that's not focused on bringing cholesterol levels down to a set value.

In the new study, researchers found that 85 percent of veterans age 50-75 with diabetes treated at the VA received appropriate care, most importantly because they were on at least moderate doses of cholesterol treatment medications called statins. But among patients 18 and older who had no known heart disease, nearly 14 percent may have unnecessarily received high-dose statin medications, putting them at risk of harm from overtreatment.

The research stems from new safety data published this year by the U.S. Food and Drug Administration (FDA) on commonly-used cholesterol-lowering medications known as statins. The FDA issued new guidelines for statin drugs warning users that the medications can cause memory loss, elevated blood sugar levels, and type-2 diabetes, in addition to muscle damage and liver disease.

"The study reveals that we may have both underuse and overuse of statins and should invigorate efforts to make sure that each patient has the opportunity to be treated in a personalized way that is best given their risk profile," says Circulation Editor and Director of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation Harlan M. Krumholz, M.D.

Authors says modern healthcare electronic record systems that combine blood pressure, prescription and other health data on individual risks such as heart disease make this method of individualized treatment possible.

The study included more than 960,000 active Veterans Affairs primary care patients 18 years of age or older with type 2 diabetes treated from July 2010 to June 2011.


Contact: Beata Mostafavi
University of Michigan Health System

Related medicine news :

1. Shady Grove Eye and Vision Care Reminds Patients to Book Appointments Now Before 2012 Flex Benefits Run Out
2. Telestroke networks can be cost-effective for hospitals, good for patients
3. Jean LaMantia Author of The Essential Cancer Treatment Nutrition Guide and Cookbook Offers Recipe and Tips for Cancer Patients and Caregivers During the Christmas Season
4. Blood Cancer Patients May Benefit From New Transplant Technique
5. Millions of patients still waiting for medical breakthroughs against neglected diseases
6. Scientists ID Gene That Shows Progression in ALS Patients
7. Patients with family history of colorectal cancer may be at risk for aggressive form of the disease
8. Older and younger chronic leukemia patients may need different therapy
9. Novel test identifies patients most likely to benefit from ALK inhibition therapy
10. RSNA: New Study Finds Brain Angioplasty and Stents Safe and Effective for Stroke Patients
11. Primary care physicians play vital role in caring for diabetes patients
Post Your Comments:
Related Image:
Patients with diabetes may not receive best treatment to lower heart disease risk
(Date:6/26/2016)... ... June 27, 2016 , ... Quality metrics are proliferating in ... ways they remain in the eye of the beholder, according to experts who offered ... The American Journal of Managed Care. For the full issue, click here . ...
(Date:6/26/2016)... ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified personal trainer is ... a fitness app. The fitness app plans to fix the two major problems leading the ... one size fits all type program , They don’t eliminate all the reasons ...
(Date:6/25/2016)... ... ... Bruton Memorial Library on June 21 due to a possible lice infestation, as reported by ... lice: the parasite’s ability to live away from a human host, and to infest common ... the event that lice have simply gotten out of control. , As lice are a ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... non-athletes recover from injury. Recently, he has implemented orthobiologic procedures as a method ... —Johnson is one of the first doctors to perform the treatment. Orthobiologics are ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events may ... to unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. To ... for healthy coping following a traumatic event. , Trauma sufferers tend to feel a ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... June 24, 2016 Research ... "Structural Electronics 2015-2025: Applications, Technologies, Forecasts" ... In-Mold Electronics, Smart Skin, Structural Health ... Structural electronics involves electronic and/or electrical ... structures, replacing dumb structures such as vehicle bodies ...
(Date:6/24/2016)... PUNE, India , June 24, 2016 ... "Pen Needles Market by Type (Standard Pen Needles, Safety ... 12mm), Therapy (Insulin, GLP-1, Growth Hormone), Mode of Purchase ... published by MarketsandMarkets, This report studies the market for ... is expected to reach USD 2.81 Billion by 2021 ...
(Date:6/23/2016)... Research and Markets has announced the addition of the ... report to their offering. ... failure, it replaces the function of kidneys by removing the ... the treatment helps to keep the patient body,s electrolytes such ... Increasing number of ESRD patients & substantial healthcare expenditure on ...
Breaking Medicine Technology: