Chain Drug Review, March 16th, 2020

DIABETES CARE REPORT Quality Measures Aim to Prevent Hypoglycemia WASHINGTON Avalere Health and the Endocrine Society have introduced the first quality measures to help health care providers assess how well they identify and care for older adults who are at increased risk of hypoglycemia low blood sugar that can be a dangerous complication of diabetes treatment A panel of diabetes experts published the quality measures which focus on outpatient treatment for people 65 years old and older with type 2 diabetes in the Endocrine Societys Journal of Clinical Endocrinology Our research has shown a lack of initiatives to address this issue Metabolism The panelists relied on their clinical background measure development expertise and insight into patient perspectives to develop the metrics The panel included endocrinologists primary care physicians diabetes educators pharmacists measurement experts and patient advocates to ensure that the quality measures reflect a variety of perspectives and a wide breadth of knowledge on hypoglycemia prevention said Dr James Rosen zweig of Hebrew SeniorLife in Boston who led the group An estimated 33 of Americans 65 or older have diabetes and this age group faces increased risk of developing hypoglycemia Hypoglycemia can lead to seizures coma and even death The Department of Health and Human Services identified hypoglycemia as one of the top three preventable and measurable adverse drug events Hypoglycemia is an area where we can make meaningful strides in improving diabetes care commented Rosenzweig Our research has shown a lack of widespread initiatives to address this issue These first of their kind quality measures will help clinicians better identify patients who are at risk and combat hypoglycemia Avalere is excited to have been involved in the development of measures focused on older adults who are at risk of having hypoglycemia commented Kristi Mitchell practice director at Avalere Health To date there has been a gap in outpatient measures that screen patients for risk of hypoglycemia and setting tailored targets for this population We look forward to continuing our work with the Hypoglycemia Prevention Initiative to address this need The quality measures outline key risk factors that raise an individuals chances of developing hypoglycemia and emphasize the importance of people who meet these criteria receiving education to help prevent future episodes Kristi Mitchell Key risk factors include Having experienced a drop in blood glucose level to below 54 mg dL which required immediate attention within the past year Having experienced altered mental or physical status requiring assistance during a severe hypoglycemic event in the past year For those individuals who manage their blood sugar with insulin or medicines like sulfonylureas that increase the risk of hypoglycemia risk factors include A documented A1c of less than 7 in the past six months At least one other relevant chronic medical problem The expert panel recommended that health care providers capture information about hypoglycemic episodes where individuals experienced altered mental or physical status requiring assistance within the past year This information can help clinicians better determine if an individual is experiencing growing unawareness of hypoglycemia over time and identify what kinds of interventions stand the best chance of helping the patient avoid future episodes of hypoglycemia Symptoms of hypoglycemia are sudden and include confusion irritability and blurred vision Once medical centers and practices begin using the quality measures the society and Avalere hope to use information and data from users to refine the quality measures in the future The work on measures was part of a broader quality improvement effort the Hypoglycemia Prevention Initiative which was launched by the Endocrine Society and Avalere to study how hypoglycemia could be prevented in older individuals with type 2 diabetes and whether primary care physicians could incorporate diagnostic and preventive services into their workflow The initiative is supported by Merck Co Lilly USA Novo Nordisk Inc Sanofi and Abbott Diabetes Care Inc Other authors of the report and recommendations include Dr Paul Conlin of VA Boston Healthcare System Jasmine Gozalvo of Purdue University in West Lafayette Ind Stephanie Kutler of the Endocrine Society Dr Nisa Maruthur of Johns Hopkins University in Baltimore Penelope Soli of Avalere Dr San deep Vijan of the University of Michigan in Ann Arbor Mich Dr Amish Wallia of Northwestern University in Evanston Ill and Robin Fein Wright of Diabetes Sisters in Bolingbrook Ill Prediabetes Needs Public Action Continued from page 53 12 for South Americans Among Asians the percentage was 23 for South Asians 22 for Southeast Asians 14 for East Asians Consistent with previous research Asians were found to have lower body mass index BMI levels compared to other racial ethnic groups In this latest study after adjusting for age sex and BMI Southeast Asians had the highest percentages of adults living with diagnosed and undiagnosed diabetes among Asian subgroups These important findings establish a baseline for future national diabetes estimates for Hispanic and non Hispanic Asian subgroups and highlight differences in the diabetes burden in these groups said Albright These data also provide insights that allow us to reach groups at higher risk and provide opportunities to strengthen diabetes detection Robert Redfield and type 2 diabetes prevention and care in these groups Most health professionals rely on BMI to assess whether their patients are overweight or have obesity BMI of 25 or greater However since Asian Americans may be at risk for type 2 diabetes even at normal weight ranges researchers are now suggesting that people of Asian heritage get tested if their BMI is 23 or greater The research was based on UltiGuard Safe Pack Worry Free for Pets EXCELSIOR Minn The Ulti Guard Safe Pack for pets has been added to the Fear Free LLC Preferred Product Program The patented system uniquely combines premium quality human grade syringes with a sharps container according to manufacturer UltiMed Inc This game changing treatment and disposal system not only provides a comfortable injection experience for the pet it also removes the concern of how to discard sharps says UltiMed UltiGuard Safe Pack syringes fit the bill said Dr Kristin Hook medical director and chief executive officer of Furever Family Veterinary Care Clinic in East Moline Ill Its already scary for owners to treat their pets diabetes so lets make the experience as worry free as possible The clinic is Fear Free Certified which means the staff works to take fear out of veterinary visits for pets and their owners UltiGuard Safe Pack not only provides human grade ultrafine insulin syringes the all in one system removes the concern about what to do with the syringes after treatment Surveys indicate that less than 5 of the more than 78 billion sharps sold in the U S annually are disposed of in a closed container The other 95 are deposited unprotected into household trash putting individuals at risk for accidental needle sticks Hook said her clinic occasionally receives plastic baggies cardboard boxes and plastic milk cartons with used syringes Ive even heard of people just throwing them in the trash she says and thats a public health concern that makes me nervous Proper disposal of sharps is recommended and required by government agencies Requirements for proper disposal vary but every state requires that sharps be placed in commercially available sharps containers or puncture resistant plastic or metal containers with a tightly secured screw on lid Clear or glass containers should not be used Containers should be labeled Sharps Do not recycle and sealed with heavy duty tape Additional options may include a mail back program fees apply medical waste collection program or a device to destroy used needles and lancets The mission of Fear Free is to prevent and alleviate fear anxiety and stress in pets by inspiring and educating the people who care for them Developed by Americas veterinarian Dr Marty Becker Fear Free offers online and in person education to veterinary professionals pet professionals and pet owners It provides professionals and pet lovers with the knowledge and tools to look after a pets physical and emotional well being UltiMed will be participating in the ECRM Home Health Diabetes Care Program from March 29 to April 1 in St Louis data from the National Health and Nutrition Examination Survey covering the years 2011 to 2016 The findings fill a national surveillance gap in Hispanic and Asian populations This landmark diabetes survey provides essential data that will better inform public health efforts to reach more Americans with tailored effective prevention and treatment strategies said Redfield This defined data on the prevalence of diabetes among Hispanic and Asian demographic groups can help health care providers and patients reduce the risk for type 2 diabetes The U S is an increasingly diverse nation as Hispanics and non Hispanic Asians collectively now account for 23 of the population and are expected to account for 38 by 2060 According to researchers these groups may be at higher risk for type 2 diabetes due to genetic lifestyle and environmental factors Chain Drug Review March 16 2020 57