Microalbuminuria – Matelich

Do we continue to follow microalbumin after diagnosing microalbuminuria?   YES - the ADA does recommend yearly checking of the eGFR and microalbumin. At T2DM - start at time of dx At T1DM - start 5 years after dx   Kidney care: Glucose control BP control < 140/90 ACE/ARB   Microalbuminuria = 30-300  Macroalbuminuria >… Continue reading Microalbuminuria – Matelich


Hot Medicine Topics – 5/23/17

HOT MEDICINE TOPICS:  23 MAY 2017 This was a great month for actual practice-changing studies!  Read on!   Should we screen extensively for occult cancer after an unprovoked DVT?  Khan, et al. BMJ 2017 22 March.   Current knowledge:  Previously reported incidences of cancer in this population was around 10%.  In practice, many patients with… Continue reading Hot Medicine Topics – 5/23/17

Screening for Pre-Diabetes Not Very Accurate

The Brits strike again, undermining what we all think we know!  The article summarized here calls into question the practice of using A1c or fasting glucose to diagnose "pre-diabetes" (a "disease" which I put in "quotations" because it's a "pre-disease.") Screening for pre-diabetes: neither HbA1c nor fasting glucose results are very accurate Clinical Question Are… Continue reading Screening for Pre-Diabetes Not Very Accurate

Long-Acting Reversible Contraception (LARC)

Adapted from NEJM 2/2/2017 review article, "Long-Acting Reversible Contraception": THE PROBLEM: Unintended pregnancies are common in the US, though decreasing from 2008 to 2011:  45% of US pregnancies are unintended (compared to 35% in W Europe).  54/1000 in 2008 down to 45/1000 in 2011. From 2011-13, only 62% of women 15-44 yo were using contraception;… Continue reading Long-Acting Reversible Contraception (LARC)

Risk vs Benefits of Post-MI Beta-Blockers in Nursing Home Residents

JAMA Intern Med 2016 Dec 12 Beta-blockers are known to prevent early mortality after an MI, but they are often not prescribed in elderly NH patients due to fear that they can worsen functional decline. Researchers studied linked Medicare claims and NH data on 11,000 NH residents (mean age, 84; mostly white women).  Post-MI patients… Continue reading Risk vs Benefits of Post-MI Beta-Blockers in Nursing Home Residents