Word: blooded
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Dates: during 2000-2009
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...When TIME visited Copenhagen in March, the EHR evolution was evidently still in progress, with the latest phase focusing on the roll out of telemedicine programs. In the past year, Denmark has piloted two home monitoring programs for patients with diabetes and patients on blood thinning medication - groups that are at high risk of expensive emergency hospitalization. For diabetics, specially trained nurses make home visits to patients with diabetic foot ulcers - which often become infected and lead to amputations. Over a secure video link, the doctor and nurse discuss the ulcers and decide a course of treatment. For patients...
...Among the patients who were screened, 5.5% needed procedures, such as bypass or angioplasty, to restore blood flow to the heart during the course of the trial. A similar proportion, 7.8%, of unscreened patients required similar procedure. The difference was not statistically significant, meaning that the screening did little to predict or prevent heart problems in diabetes patients...
...reason that screening didn't appear to provide any health advantage, Wackers theorizes, may be that patients with diabetes (particularly the ones being monitored carefully in the study) are already benefiting from well controlled blood sugar - in patients, both with diabetes and without, high blood sugar is associated with increased heart risk. So, if diabetes patients are already being treated for potential heart risk factors before they become hazardous, screening becomes redundant...
...With his latest findings, however, Wackers thinks the ADA guidelines are ready for a revision. Heart screenings may not be as important as basic primary prevention strategies, such as ensuring that diabetes patients control their weight, cholesterol and blood pressure, and stop smoking. He argues that if the rate of heart problems is indeed declining in diabetes patients because they are being adequately treated for the risk factors for heart disease, then the stress test recommendation becomes redundant - and expensive...
...results show that with standard of care, diabetes patients actually do quite well," he says. "I believe now that it's far more important to do primary prevention, such as keeping cholesterol levels on target, and blood pressure controlled, and not smoking...