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The gap in Medicare prescription drug coverage, or the doughnut hole, may be why many seniors with diabetes are not adhering to medications. Researchers from Kaiser Permanente and the David Geffen School of Medicine at the University of California, Los Angeles, focused their study on what happens during the gap, or when patients are paying for their medications out of pocket.1

Health care spending in the United States slowed to a growth rate of 4.4% in 2008-the slowest in 48 years-as national health spending reached $2.3 trillion ($7681 per person). These results were published in an annual report from the National Health Expenditure Accounts Team.1

A 62-year-old woman presents with epistaxis from the right nostril. Thenosebleed has lasted about 90 minutes, and she has become alarmedby the amount of blood on the tissues and washcloth she has applied to hernose.

A recent study has shown that rates of disability may be rising among noninstitutionalized adults 65 years and older in the United States.1 “People are living longer, but many are also living sicker,” said Amani Nuru-Jeter, PhD, MPH, assistant professor of community health and human development at the University of California Berkeley School of Public Health, and coauthor of the study.

Although policymakers continue to push for greater adoption of electronic medical records (EMRs), physicians already using these systems report difficulty in exchanging data because of program interoperability, according to a new report.1 “We found that many aspects of the EMRs are helpful for coordination of care delivered within the physician’s office,” said Ann S. O’Malley, MD, MPH, lead study author and senior researcher at the Center for Studying Health System Change, in an interview with Drug Benefit Trends. “But there are areas for both office care processes and EMR design to evolve in order for EMRs to better support coordination tasks.”

Cephalosporins are usually considered relatively safe antibiotics; however, serious neurological adverse effects can occur following administration.1-5 Manifestations of cephalosporin-induced neurotoxicity may include confusion, disorientation, twitching, somnolence, myoclonus, and seizures, particularly in patients with reduced renal function.6,7 Here we discuss the mechanism, risk factors, and management of cephalosporin-induced neurotoxicity.

A 92-year-old woman presented with signs and symptoms of heart failure, including marked bilateral lower extremity edema, jugular vein distention, and difficulty in breathing at rest. Her medical history was significant for hyperthyroidism, chronic asthmatic bronchitis, and senile dementia. Medications included oral methimazole, 10 mg/d, and oral theophylline, 200 mg/d.

Podcasts from NIH • Intensive Glucose Control Halves Complications of Longstanding Type 1 Diabetes/Family Risk for Diabetes, Pre-diabetes • NIDDK Resource to Help Guide Diabetic Women Through a Healthy Pregnancy • Older Treatment Is More Effective than New Treatment in Preserving Sight for Some Patients with Diabetes • The Unique Effects of Diabetes on Women

Consultations and Commentaries • Should Patients With Asymptomatic Celiac Disease Forgo Gluten? • How to Manage Insulin Resistance in Children • Can High-Sugar Foods Be Eaten in a Manner That Supports Health? • If Diabetes Is Multifactorial, Why the Spotlight on Obesity? 

On This Page • Diabetes Q&A • Images in Diabetes • Juvenile Diabetes  • Diabetes and Mental Health • Guidelines and Recommendations • News • Patient Resources • Tools

Glycemic Control and Type 2 Diabetes Mellitus: The Optimal Hemoglobin A1c Targets. A Guidance Statement from the American College of Physicians 

Diabetes is one of the most common and most challenging diseases in primary care. How best to help your patients achieve glycemic control? To that end, we have created this resource page.

To save time and minimize pain and tissue trauma when injecting a joint or soft tissue with a corticosteroid, use a single needle and 2 screw-on syringes. Fill the first syringe with lidocaine and the second with the corticosteroid, then lightly but securely attach the first syringe to the needle. After inserting the needle and achieving local analgesia in the desired location, simply leave the needle in place and, while holding it firmly, switch the syringes; then inject the corticosteroid.

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