Do patients with type 2 diabetes who aren't taking insulin benefit from self-monitoring blood glucose?

Patients with type 2 diabetes who aren't on insulin and perform self-monitoring of blood glucose (SMBG) show small but significant reductions in hemoglobin A1c (HbA1c) at 6 months but not at 12 months (strength of recommendation [SOR]: B, systematic reviews and meta-analyses of disease-oriented evidence). Patients with a baseline HbA1c 8% do (SOR: B, systematic reviews and meta-analyses of disease-oriented evidence). More frequent SMBG--4 to 7 times weekly--doesn't reduce HbA1c more than less frequent self-monitoring--1 or 2 times a week (SOR: B, a systematic review and meta-analysis of disease-oriented evidence)

Role of Statin Drugs for Polycystic Ovary Syndrome

Objective: To review the potential role and specific impact of statin drugs in women with PCOS. The evidence for this use of statins in PCOS is limited and still under further investigation. Materials and methods: A search was conducted using PubMed, DynaMed and PubMedHealth databases through October 16, 2016 using the terms polycystic ovary syndrome, PCOS, hydroxymethylglutaryl-CoA reductase inhibitors, hydroxymethylglutaryl-CoA , statin, atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin and simvastatin. English-language trials evaluating statins in PCOS were obtained and incorporated if they provided relevant data for providers. Results: We summarize twelve trials involving statins in PCOS. The trials were predominantly 12 weeks to 3 months in length (8 of the 12 trials) and low to moderate dose of statin drugs were used. The majority (10 of 12) of the trials show that statins reduce testosterone levels or other androgen hormones (DHEA-S and androstenedione), half of the trials evaluating LH/FSH ratio show an improvement, and all had positive effects on lipid profiles. Conclusion: Statins show promising improvements in serum levels of androgens and LH/FSH ratios translating to improved cardiovascular risk factors above and beyond simply lowering LDL levels. More investigation is needed to determine if statins can clinically impact women with PCOS long term, particularly those who are young and are not yet candidates for traditional preventative treatment with a statin medication.

Use of Amantadine for Chronic Fatigue Syndrome

Fatigue is a chronic and debilitating hallmark of the chronic fatigue syndrome, which is often accompanied by sleep disturbances, myalgias, and depression.1,2 This condition has been reported worldwide, and case definitions have been developed by the Centers for Disease Control and Prevention.3 Amantadine hydrochloride has been used to treat fatigue associated with conditions such as multiple sclerosis.4-6 We investigated the symptomatic effects of amantadine on 4 patients with chronic fatigue syndrome using a multiple single-subject trial design.7Patients who had a diagnosis of chronic fatigue made by their family physicians and who fulfilled the criteria for chronic fatigue syndrome defined by the Centers for Disease Control and Prevention were included.3 Using a multiperiod, crossover design,8 with a single subject for each sequence, patients received either placebo (B) or amantadine hydrochloride (A), 100 mg twice daily. Patients were blinded to treatment identification

Use of Amantadine for Chronic Fatigue Syndrome

Fatigue is a chronic and debilitating hallmark of the chronic fatigue syndrome, which is often accompanied by sleep disturbances, myalgias, and depression.1,2 This condition has been reported worldwide, and case definitions have been developed by the Centers for Disease Control and Prevention.3 Amantadine hydrochloride has been used to treat fatigue associated with conditions such as multiple sclerosis.4-6 We investigated the symptomatic effects of amantadine on 4 patients with chronic fatigue syndrome using a multiple single-subject trial design.7Patients who had a diagnosis of chronic fatigue made by their family physicians and who fulfilled the criteria for chronic fatigue syndrome defined by the Centers for Disease Control and Prevention were included.3 Using a multiperiod, crossover design,8 with a single subject for each sequence, patients received either placebo (B) or amantadine hydrochloride (A), 100 mg twice daily. Patients were blinded to treatment identification

Racial and ethnic disparities in self-monitoring of blood glucose among US adults: a qualitative review.

Despite widespread recommendations for self-monitoring of blood glucose, compliance is reported to be low in all groups in the United States, especially among racial/ ethnic minorities

Ethnic disparities: control of glycemia, blood pressure, and LDL cholesterol among US adults with type 2 diabetes.

OBJECTIVE: To examine ethnic disparities in the quality of diabetes care among adults with diabetes in the US through a systematic qualitative review. DATA SOURCES: Material published in the English language was searched from 1993 through June 2003 using PubMed, Web of Science, Cumulative Index to Nursing and Allied Health, the Cochrane Library, Combined Health Information Database, and Education Resources Information Center. STUDY SELECTION AND DATA EXTRACTION: Studies of patients with diabetes in which at least 50% of study participants were ethnic minorities and studies that made ethnic group comparisons were eligible. Research on individuals having prediabetes, those <18 years of age, or women with gestational diabetes were excluded. Reviewers used a reproducible search strategy. A standardized abstraction and grading of articles for publication source and content were used. Data on glycemia, blood pressure, and low-density lipoprotein cholesterol (LDL-C) were extracted in patients with diabetes. A total of 390 studies were reviewed, with 78 meeting inclusion criteria. DATA SYNTHESIS: Ethnic minorities had poorer outcomes of care than non-Hispanic whites. These disparities were most pronounced for glycemic control and least evident for LDL-C control. Most studies showed blood pressure to be poorly controlled among ethnic minorities. CONCLUSIONS: Control of risk factors for diabetes (glycemia, blood pressure, LDL-C) is challenging and requires routine assessment. These findings indicate that additional efforts are needed to promote diabetes quality of care among minority populations