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Medicine by the numbers

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AAN, AANEM, and AAPMR Publish Guideline for Treatment of Painful Diabetic Neuropathy - ...

Sep 1, 2012 - Painful diabetic neuropathy is a chronic disease that affects approximately 16 percent of patients who have diabetes mellitus. The American Academy of Neurology (AAN), the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM), and the American Academy of Physical ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2012/0901/p469.html

ACE Inhibitors vs. ARBs for Patients with Diabetic Kidney Disease - Cochrane for ...

Jul 1, 2007 - Studies comparing ACE inhibitors or ARBs with placebo found no mortality benefit in patients with diabetic kidney disease. A subgroup analysis of five studies (2,034 total patients) found that, when given at full or maximally tolerated doses, ACE inhibitors reduce all-cause mortality ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0701/p68.html

ACP Releases Guideline on Lipid Control in Patients with Type 2 Diabetes Mellitus - ...

Aug 15, 2004 - A guideline on the management of dyslipidemia, particularly hypercholesterolemia, in patients with type 2 diabetes mellitus has been published by the Clinical Efficacy Assessment Subcommittee of the American College of Physicians (ACP).

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2004/0815/p775.html

Angiotensin Blockade in Patients with Diabetic Nephropathy - FPIN's Clinical Inquiries ...

Aug 1, 2007 - When used to delay the progression of early nephropathy in patients with type 2 diabetes mellitus, angiotensin receptor blockers (ARBs) are not superior to angiotensin-converting enzyme (ACE) inhibitors.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2007/0801/p423.html

Antihypertensive Agents for Prevention of Diabetic Nephropathy - Cochrane for ...

Jul 1, 2006 - Angiotensin-converting enzyme (ACE) inhibitors are the only antihypertensive agents with proven effectiveness for the primary prevention of diabetic nephropathy (defined as an albumin excretion of less than 30 mg per day on three serial measurements) caused by type 1 or type 2 diabetes....

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0701/p77.html

Aromatase Inhibitors Such as Letrozole (Femara) vs. Clomiphene (Clomid) for Subfertile ...

May 1, 2019 - When treated with letrozole, subfertile women with PCOS who are trying to conceive have increased chances of pregnancy (number needed to treat [NNT] = 11) and live birth (NNT = 10) compared with those treated with clomiphene.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0501/p545.html

Attenuating Cardiovascular Risk Factors in Patients with Type 2 Diabetes - American ...

Dec 15, 2000 - Patients with type 2 diabetes (formerly known as non-insulin-resistant diabetes) have a significantly increased risk of developing cardiovascular disease. Once clinical cardiovascular disease develops, these patients have a poorer prognosis than normoglycemic patients. By inducing ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1215/p2633.html

Becaplermin (Regranex) for Diabetic Foot Ulcers - STEPS - American Family Physician

Jul 15, 2008 - Although patients treated with becaplermin are more likely to experience complete and faster ulcer healing than patients continuing good wound care alone, the increased risk of cancer mortality and significant cost outweigh the possible benefits in most patients.

American Family Physician : STEPS

https://www.aafp.org/afp/2008/0715/p255.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

Choosing First-Line Therapy for Management of Type 2 Diabetes - AFP Journal Club - ...

Jan 1, 2008 - Which controls type 2 diabetes best at five years: rosiglitazone, metformin, or glyburide? Metformin should be the first-line drug for managing type 2 diabetes. Insulin and sulfonylureas should be second line, and glitazones should be reserved for third line.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0101/p16.html

Combination Therapy for Type 2 Diabetes - Editorials - American Family Physician

Dec 1, 2001 - ...University of Alabama at Birmingham School of Medicine, Birmingham, Alabama Am Fam Physician. 2001 Dec 1;64(11):1812-1815. Until just over six years ago, patients with type 2 diabetes were started on treatment with a sulfonylurea. When this treatment failed, insulin was added to or...

American Family Physician : Editorials

https://www.aafp.org/afp/2001/1201/p1812.html

Dapagliflozin (Farxiga) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jun 15, 2015 - Dapagliflozin will lower A1C levels by an average of 0.7 percentage points when used alone or by an average of 0.5 percentage points when added to metformin therapy. Its effect on diabetes-associated morbidity and mortality has not been studied, and although it is well tolerated, there ...

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0615/p828.html

Dapagliflozin in High-Risk Type 2 Diabetes Reduces Hospitalization for Heart Failure ...

Aug 1, 2019 - The only cardiovascular benefit to treatment with dapagliflozin was a reduction in the likelihood of hospitalization; 125 patients would need to be treated for 10 years to prevent one hospitalization.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p184.html

Denosumab for Reducing Risk of Fractures in Postmenopausal Women - Medicine by the ...

May 1, 2019 - Denosumab appears to be effective in reducing the risk of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Treatment with denosumab does not increase the risk of cancer or death but might increase the risk of infection. However, more studies are required.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0501/od1.html

Diabetes Mellitus: Diagnosis and Screening - American Family Physician

Apr 1, 2010 - Based on etiology, diabetes is classified as type 1 diabetes mellitus, type 2 diabetes mellitus, latent autoimmune diabetes, maturity-onset diabetes of youth, and miscellaneous causes. The diagnosis is based on measurement of A1C level, fasting or random blood glucose level, or oral ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0401/p863.html

Diabetes Mellitus: Screening and Diagnosis - American Family Physician

Jan 15, 2016 - Diabetes mellitus is one of the most common diagnoses made by family physicians. Uncontrolled diabetes can lead to blindness, limb amputation, kidney failure, and vascular and heart disease. Screening patients before signs and symptoms develop leads to earlier diagnosis and treatment, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0115/p103.html

Diabetes: Type 2 - American Family Physician

Aug 1, 2019 - This collection features AFP content on type 2 diabetes and related issues, including blood glucose levels, diabetic complications (such as ketoacidosis and neuropathy), glycemic control, insulin management, and gestational diabetes. This collection features AFP content on type 2 ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=7

Diabetic Foot Ulcers: Pathogenesis and Management - American Family Physician

Nov 1, 2002 - Foot ulcers are a significant complication of diabetes mellitus and often precede lower-extremity amputation. The most frequent underlying etiologies are neuropathy, trauma, deformity, high plantar pressures, and peripheral arterial disease. Thorough and systematic evaluation and ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1101/p1655.html

Diabetic Kidney Disease: Diagnosis, Treatment, and Prevention - American Family Physician

Jun 15, 2019 - Globally, approximately 20% of the 400 million individuals with diabetes mellitus have diabetic kidney disease (DKD). DKD is associated with higher cardiovascular and all-cause morbidity and mortality, so timely diagnosis and treatment are critical. Screening for early DKD is best done ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p751.html

Diabetic Nephropathy--The Family Physician's Role - American Family Physician

May 1, 2012 - Nearly one-half of persons with chronic kidney disease have diabetes mellitus. Diabetes accounted for 44 percent of new cases of kidney failure in 2008. Diabetic nephropathy, also called diabetic kidney disease, is associated with significant macrovascular risk, and is the leading cause...

American Family Physician : Article

https://www.aafp.org/afp/2012/0501/p883.html

Diabetic Nephropathy: Common Questions - American Family Physician

Jul 1, 2005 - Diabetic nephropathy, or diabetic kidney disease, affects 20 to 30 percent of patients with diabetes. It is a common cause of kidney failure. Diabetic nephropathy presents in its earliest stage with low levels of albumin (microalbuminuria) in the urine. The most practical method of ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0701/p96.html

Diagnosing and Treating Hair Loss - American Family Physician

Aug 15, 2009 - Physicians should be careful not to underestimate the emotional impact of hair loss for some patients. Patients may present with focal patches of hair loss or more diffuse hair loss, which may include predominant hair thinning or increased hair shedding. Focal hair loss can be further ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0815/p356.html

Diagnosis and Management of Gestational Diabetes Mellitus - American Family Physician

Jul 1, 2009 - Gestational diabetes occurs in 5 to 9 percent of pregnancies in the United States and is growing in prevalence. It is a controversial entity, with conflicting guidelines and treatment protocols. Recent studies show that diagnosis and management of this disorder have beneficial effects ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0701/p57.html

Diagnosis and Management of Osteoporosis - American Family Physician

Aug 15, 2015 - Osteoporosis-related fractures affect approximately one in two white women and one in five white men in their lifetime. The impact of fractures includes loss of function, significant costs, and increased mortality. The U.S. Preventive Services Task Force recommends using dual energy ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0815/p261.html

Diagnosis and Treatment of Osteoporosis - American Family Physician

Feb 1, 2009 - Osteoporosis affects approximately 8 million women and 2 million men in the United States. The associated fractures are a common and preventable cause of morbidity and mortality in up to 50 percent of older women. The U.S. Preventive Services Task Force recommends using dual energy ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0201/p193.html

Does Metformin Increase the Risk of Fatal or Nonfatal Lactic Acidosis? - Cochrane for ...

Nov 1, 2010 - In patients without standard contraindications to metformin therapy, metformin does not increase the risk of lactic acidosis.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2010/1101/p1068.html

Does Pioglitazone Benefit Patients With Type 2 Diabetes? - Cochrane for Clinicians - ...

Oct 1, 2007 - Pioglitazone produces a reduction in A1C levels similar to that produced by other drugs. One trial found that although pioglitazone, used as an adjunct to other antihyperglycemic medications, may lead to a statistically significant reduction in morbidity and mortality in patients with ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/1001/p969.html

Duration of Bisphosphonate Therapy - FPIN's Help Desk Answers - American Family Physician

Apr 1, 2018 - Oral bisphosphonates significantly reduce clinical fracture risk at four years in women with postmenopausal osteoporosis (T-score less than −2.5). Treatment beyond five years is associated with further reductions in fractures in women with persistent femoral neck T-scores less than −2.5.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od1.html

Educational Guidelines for Achieving Tight Control and Minimizing Complications of Type...

Nov 1, 1999 - Tight glucose control with intensive therapy in patients with type 1 diabetes (formerly known as juvenile-onset or insulin-dependent diabetes) can delay the onset and slow the progression of retinopathy, nephropathy and neuropathy. Optimal blood glucose control is defined by a target ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1101/p1985.html

Evaluation and Treatment of Galactorrhea - American Family Physician

May 1, 2001 - Galactorrhea, or inappropriate lactation, is a relatively common problem that occurs in approximately 20 to 25 percent of women. Lactation requires the presence of estrogen, progesterone and, most importantly, prolactin. Stress, suckling, sleep, sexual intercourse and medications may ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0501/p1763.html

Evaluation of Short and Tall Stature in Children - American Family Physician

Sep 1, 2008 - Children and adolescents whose heights and growth velocities deviate from the normal percentiles on standard growth charts present a special challenge to physicians. Height that is less than the 3rd percentile or greater than the 97th percentile is deemed short or tall stature, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0901/p597.html

Exenatide Injection (Byetta): Adjunctive Therapy for Glycemic Control - STEPS - ...

Jun 15, 2006 - Exenatide is an injectable treatment for type 2 diabetes. Its use requires patient education and strict monitoring of glucose levels because of the difficulty of its administration; therefore, it may not be a safe or practical option for patients who are not willing or able to ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0615/p2213.html

Facilitating Treatment Adherence With Lifestyle Changes in Diabetes - American Family ...

Jan 15, 2004 - Healthy eating and increased physical activity can prevent or delay diabetes and its complications. Techniques that facilitate adherence to these lifestyle changes can be adapted to primary care. Often, the patient's readiness to work toward change must be developed gradually. To ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0115/p309.html

Glucose Control in Hospitalized Patients - American Family Physician

May 1, 2010 - Evidence indicates that hospitalized patients with hyperglycemia do not benefit from tight blood glucose control. Maintaining a blood glucose level of less than 180 mg per dL (9.99 mmol per L) will minimize symptoms of hyperglycemia and hypoglycemia without adversely affecting ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0501/p1121.html

Glucose Management in Hospitalized Patients - American Family Physician

Nov 15, 2017 - Glucose management in hospitalized patients poses challenges to physicians, including identifying blood glucose targets, judicious use of oral diabetes mellitus medications, and implementing appropriate insulin regimens. Uncontrolled blood glucose levels can lead to deleterious effects ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p648.html

Glycemic Control in Patients with Type 2 Diabetes - FPIN's Clinical Inquiries - ...

Apr 1, 2007 - There is no clearly superior oral agent for glycemic control in patients with type 2 diabetes.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2007/0401/p1051.html

Gynecomastia - American Family Physician

Apr 1, 2012 - Gynecomastia is defined as benign proliferation of glandular breast tissue in men. Physiologic gynecomastia is common in newborns, adolescents, and older men. It is self-limited, but can be treated to minimize emotional distress and physical discomfort. Nonphysiologic gynecomastia may ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0401/p716.html

Hair Loss: Common Causes and Treatment - American Family Physician

Sep 15, 2017 - Hair loss is often distressing and can have a significant effect on the patient’s quality of life. Patients may present to their family physician first with diffuse or patchy hair loss. Scarring alopecia is best evaluated by a dermatologist. Nonscarring alopecias can be readily ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0915/p371.html

High-Dose vs. Standard-Dose Heparin for VTE Prophylaxis in Obese Patients - FPIN's Help...

Jun 1, 2018 - In most patients weighing more than 220 lb (100 kg), high-dose heparin prophylaxis (7,500 units subcutaneously three times per day) does not further reduce the risk of VTE compared with standard-dose heparin (5,000 units subcutaneously two or three times per day).

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0601/od2.html

Hirsutism in Women - American Family Physician

Aug 1, 2019 - Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. Less ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p168.html

Home Monitoring of Glucose and Blood Pressure - American Family Physician

Jul 15, 2007 - Home monitoring of blood glucose and blood pressure levels can provide patients and physicians with valuable information in the management of diabetes mellitus and hypertension. Home monitoring allows patients to play an active role in their care and may improve treatment adherence and ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0715/p255.html

Hyperglycemic Crises: Improving Prevention and Management - Editorials - American ...

May 1, 2005 - ...it also has been shown that quarterly visits for children with type 1 diabetes to endocrine clinics can significantly reduce the number of emergency admissions for DKA.12 A prospective study of 1,243 patients with type 1 diabetes from infancy to 19 years of age showed that elevated...

American Family Physician : Editorials

https://www.aafp.org/afp/2005/0501/p1659.html

Hyperhidrosis: Management Options - American Family Physician

Jun 1, 2018 - Hyperhidrosis is excessive sweating that affects patients’ quality of life, resulting in social and work impairment and emotional distress. Primary hyperhidrosis is bilaterally symmetric, focal, excessive sweating of the axillae, palms, soles, or craniofacial region not caused by other ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0601/p729.html

Hyperthyroidism: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Hyperthyroidism is an excessive concentration of thyroid hormones in tissues caused by increased synthesis of thyroid hormones, excessive release of preformed thyroid hormones, or an endogenous or exogenous extrathyroidal source. The most common causes of an excessive production of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p363.html

Hypothyroidism: An Update - American Family Physician

Aug 1, 2012 - Hypothyroidism is a clinical disorder commonly encountered by the primary care physician. Untreated hypothyroidism can contribute to hypertension, dyslipidemia, infertility, cognitive impairment, and neuromuscular dysfunction. Data derived from the National Health and Nutrition ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0801/p244.html

Ibandronate (Boniva) for Treatment and Prevention of Osteoporosis in Postmenopausal ...

Jan 15, 2006 - Ibandronate is a bisphosphonate that can be taken daily or monthly. The daily dosage has been shown to decrease vertebral fractures in women with osteoporosis and a history of previous vertebral fractures. Neither formulation has been shown to reduce the risk of hip fracture or other ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0115/p305.html

Impaired Glucose Tolerance and Impaired Fasting Glucose - American Family Physician

Apr 15, 2004 - Impaired glucose tolerance and impaired fasting glucose form an intermediate stage in the natural history of diabetes mellitus. From 10 to 15 percent of adults in the United States have one of these conditions. Impaired glucose tolerance is defined as two-hour glucose levels of 140 to ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0415/p1961.html

Insulin Detemir (Levmir) for Diabetes Mellitus - STEPS - American Family Physician

Jul 15, 2006 - Insulin detemir is suitable as basal insulin in a basal-bolus regimen. In limited research, it has been shown to cause slightly fewer episodes of minor hypoglycemia and no weight gain in patients with type 1 and 2 diabetes, which is a benefit that must be balanced against its higher ...

American Family Physician : STEPS

https://www.aafp.org/afp/2006/0715/p323.html

Insulin for Glycemic Control in Acute Ischemic Stroke - Cochrane for Clinicians - ...

Dec 1, 2012 - Administering insulin to maintain glycemic control does not improve the rates of mortality or dependency, or the final neurologic outcome after an acute ischemic stroke. Additionally, in randomized controlled trials, patients in the intervention groups (those under tight glycemic ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/1201/p1008.html

Insulin Therapy for Type 2 Diabetes: Rescue, Augmentation, and Replacement of Beta-Cell...

Aug 1, 2004 - Type 2 diabetes is characterized by progressive beta-cell failure. Indications for exogenous insulin therapy in patients with this condition include acute illness or surgery, pregnancy, glucose toxicity, contraindications to or failure to achieve goals with oral antidiabetic ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0801/p489.html

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