Patient Care Endocrinology & Cardiology - October 2007 - (Page 9)

MEDICINE in the News Dear Doctor, Associated with an increased risk for type 2 diabetes and cardiovascular disease, the metabolic syndrome is mainly a result of the overweight and obesity epidemic. Our cover story, “Recognizing and managing patients with the metabolic syndrome and prediabetes” (page 10), by Maria V. Gibson, MD, PhD, and A. Kesh Hebbar, MD, provides the information you need to better identify this condition and intervene effectively. Troponins are proteins involved in the regulation and mediation of cardiac contraction. Cardiac troponin levels can have important prognostic implications and often guide the course of treatment in patients with acute coronary syndromes, MI, and other illnesses. In “Using troponins to evaluate cardiac injury” (page 20), our expert, Matthew DeCaro, MD, shows how to best use these important tests in clinical practice. Readers can earn CME credit by going to ModernMedicine.com. We hope that you continue to find that Patient Care’s Primary Care Topics in Endocrinology & Cardiology provides you with a practical and concise review of the important medical management issues in your practice. Ezra A. Amsterdam, MD Richard J. Comi, MD Medical Editors At the ADA: Glitazones on the mat and other concerns at S teven Nissen, MD, opened his remarks67tha special symposium, “Perspectives: Rosiglitazone—Science and Public Health,” at the Annual Scientific Sessions of the American Diabetes Association (ADA) by acknowledging that he had “made life more difficult for many of you in the last few months” by his widely publicized critique of the diabetes drug rosiglitazone. But he did not back down from his analysis of 42 short-term studies that showed an increased risk of MI with rosiglitazone and noted that the FDA’s hasty approval of rosiglitazone had ignored “strong signals of excess myocardial infarction.”1 In August 2007, the FDA said that after reviewing postmarketing adverse-event reports and finding cases of significant weight gain and edema—warning signs of heart The FDA’s hasty failure—it decided that all type 2 diaapproval of betes drugs in the thiazolidinedione rosiglitazone had class should carry ignored “strong the warning. The manufacturers of signals of Avandia (rosiglitazone) and Actos (piexcess MI.” oglitazone) agreed to add a boxed warning about the risk of heart failure with the drugs. Studies of importance to primary care practitioners at the ADA meeting included several presentations on self-monitoring, screening, and glycated hemoglobin A1c standards. Self-monitoring Patients with type 2 diabetes who do not use insulin may not need intensive self-monitoring to control their disease. A 1year study from the United Kingdom found that patients whose only monitoring was an HbA1c every 3 months had glycated hemoglobin A1c levels that were similar to those of patients who tested themselves 6 times a week.2 Continued on page 19 OCTOBER 2007 PATIENT CARE ENDOCRINOLOGY & CARDIOLOGY 9 http://ModernMedicine.com

Table of Contents Feed for the Digital Edition of Patient Care Endocrinology & Cardiology - October 2007

Patient Care - Endocrinology & Cardiology - October 2007 Research Digest Contents Medicine in the News Recognizing and Managing Patients with the Metabolic Syndrome and Prediabetes Using Troponins to Evaluate Cardiac Injury The 15-Minute Visit Classified Advertising Clinical Clips

Patient Care Endocrinology & Cardiology - October 2007

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