In people with Type 1 diabetes, the pancreas can’t make insulin. Those with the condition require several doses of insulin a day and spent $5,705 per person on it in 2016, an increase of $2,841, or 99%, per person since 2012, according to the nonprofit Health Care Cost Institute.
(Podcast interview “This Weekend With Gordon Deal”, 12-14-19)
Costs continue to rise, so much so that almost half of people with diabetes have temporarily skipped taking their insulin, according to a 2018 survey by UpWell Health, a Salt Lake City company that provides home delivery of medications and supplies for chronic conditions.
“Insulin prices doubled in a four-year period,” said Cathy Paessun, the director of the Central Ohio Diabetes Association. “They continue to go up, and the infuriating thing is that there is no change in the process for creating the product.”
After operations, frail patients find it harder than others to regain strength and mobility, and to return to independent lives. Doctors and researchers assess frailty in a variety of ways. Geriatricians often measure things like gait and grip strength, and look for unintended weight loss and exhaustion.
From a British Medical Journal (BMJ) online article:
…primary care providers (general practice, paediatrics, and internal medicine) performed the best, giving a considerably lower percentage of antibiotic prescriptions without a documented indication (12%) than other specialists such as gynaecologists and urologists, who commonly prescribed antibiotics (24%), as well as those in all other specialties (29%).
As many as two in five antibiotic prescriptions (43%) provided in outpatient settings in the US could be inappropriate, a study published by The BMJ has found.1
Researchers from Oregon, USA, looked at prescriptions in ambulatory settings such as primary care and found that a quarter (25%) were deemed to be inappropriate, while a further 18% did not have an indication.
From a Genetic Engineering & Biotechnology News release:
“Our work provides additional evidence that that diet matters,” Millen added. “From a public health standpoint, we can tell people that if you have early AMD, it is likely in your best interest to limit your intake of processed meat, fried food, refined grains, and high-fat dairy to preserve your vision over time.”
The condition is called late-stage age-related macular degeneration (AMD), which is irreversible and affects a person’s central vision, taking away their ability to drive, among other common daily activities.
“There are two important takeaways from this paper. One is that poor sleep is associated with brain immune dysregulation or dysfunction,” says Lim, the corresponding author for the paper.
“The second part is that dysfunction appears to be further associated with impaired cognition.”
The study shows that in adults with fragmented sleep – where people were waking up repeatedly instead of sleeping soundly – there was an effect on microglia, and the cells showed signs of accelerated aging and other abnormalities.
The researchers were then able to identify that these changes in the microglia could be associated with worse cognition in older adults, both with and without Alzheimer’s disease.
Sleep problems may decrease the likelihood of recovery from chronic low back pain (LBP) over the long term and those who have musculoskeletal pain on top of insomnia have an even lower possibility of recovery, a study has found.
“The probability of recovery [from LBP] is especially low among persons who often/always experience sleeplessness and who also suffer from co-occurring musculoskeletal pain,” the researchers write.
The study took place over more than 10 years and also found the likelihood of recovery from chronic LBP decreased further among people with muscle and joint pains, in addition to sleeplessness.
The researchers conducted a prospective cohort study that included 3712 women and 2488 men aged at least 20 years who participated in the HUNT study, one of the largest, longest running health studies in Norway. HUNT began in 1984 and has data on over 120,000 participants.
Telemedicine extends care accessibility to people with epilepsy, who may be unable to drive to appointments, as well as people with mobility issues stemming from neurologic disorders such as multiple sclerosis. Virtual care also helps address geographic barriers by allowing patients in rural areas to see a neurologist through telemedicine technology instead of having to travel hours for in-person care, said lead author Jaime Hatcher-Martin, MD, PhD, a member of AAN, according to the news release.
The studies’ analysis found that patients and their caregivers were equally satisfied with virtual physician visits and in-person appointments. Some studies showed that the use of telemedicine is as effective as in-person care to make accurate diagnoses. However, the researchers noted that there have been few randomized, controlled studies on telemedicine for neurology apart from stroke care.