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Anchor lead: The FDA has warned against buying glucose meter test strips privately, Elizabeth Tracey reports

If you have diabetes and test your blood sugar regularly, you know that glucose test strips are often very expensive, so you may be tempted to buy them from Ebay or elsewhere to save money. Don’t, the FDA has warned. Rita Kalyani, a diabetes expert at Johns Hopkins, explains why.

Kalyani: Even if it’s in the packaging you don’t know if it’s expired, if it’s been stored properly, if its been tampered with, these test strips really need to be stored and properly used in order for them to appropriately report blood glucose. It really has to come in the package, and it really has to be sold by the people who are licensed to sell them. So the FDA has issued a warning that patients should not buy unopened vials of glucose test strips because there’s no way of knowing whether they are still in good condition to be used.   :30

Kalyani says that newer technologies are on the horizon that may make glucose test strips obsolete, and other management strategies may allow you to test less often to save money, but don’t buy privately. At Johns Hopkins, I’m Elizabeth Tracey.

 

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Anchor lead: A new class of drugs is very effective at reducing LDL cholesterol, Elizabeth Tracey reports

PCSK9 inhibitors. The name doesn’t exactly roll off the tongue but several new studies have shown that this class of injectable medications is very effective at reducing LDL cholesterol. Michael Blaha, a preventive cardiology expert at Johns Hopkins, describes what’s known.

Blaha: The PCSK9 class of drugs are an extremely exciting class that lowers LDL cholesterol up to fifty to seventy percent on top of a statin. What we not known until recently was whether adding a PCSK9 inhibitor to a statin led to further reductions in heart attacks and strokes. What we now know from the FOREY trial that adding evolucumab on top of a statin led to a further 50-70 percent reduction in LDL cholesterol, and a further 15-20 percent reduction in heart attacks and strokes on top of a statin.  :32

Blaha says for right now, these drugs will be limited to people with very high cholesterol who aren’t responding adequately to statins, since the drugs are very expensive and must be injected, usually every couple of weeks. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Why don’t people take vaccines when they’re recommended? Elizabeth Tracey reports

Let’s say you’re going on an Amazon river cruise, or a safari in Africa, and when you go to get your necessary vaccinations you are told you also are eligible for measles vaccine. Would you take it? A recent study in Annals of Internal Medicine showed that a large number of adults elected not to receive the measles vaccine. Patricia Davidson, dean of the Johns Hopkins School of Nursing, says those who work in the health care field must lead the way.

Davidson: As health professionals we do not want to be the vectors of conditions. We have a real responsibility to be up to date. But this whole debate about vaccination really is a juxtaposition of individual rights versus broader social responsibility. Broader social responsibility makes for a just, civil, prosperous and safe society. How do we present these arguments in a way that are cogent, data-driven, and accessible to a wide range of people?  :33

There is currently a large measles outbreak here in the US. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Should the US continue its investment in global health? Elizabeth Tracey reports

Under the Trump administration the US is slated to reduce and restrict support to many global health efforts, a recent study in the Lancet revealed. While such cuts may be initially attractive from a strictly monetary perspective, they may be quite short sighted with regard to preserving health right here in the US. That’s according to Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health.

Klag: We have to view global health and aid as an investment. It’s an investment in the health of the world but it’s an investment in the health of the United States. They give the example of SARS, severe acute respiratory syndrome, which happened in 2003. It only lasted a few months. In those few months it cost the world somewhere around 50 billion dollars. In the US alone, in Ebola outbreak, we had one death of an imported case and then several people got infected. We spent 5.4 billion dollars in response to that epidemic. The point is that keeping the world safe keeps us safe.  :32

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Women who receive abortion services online have few complications, Elizabeth Tracey reports

Are online abortion services safe? That question was addressed in a recent study of women living in Ireland, which has very restricted surgical abortion. The study found that in over 1000 women who accessed the online service, medical abortion was safe and effective for the overwhelming majority. Mike Klag, dean of the Johns Hopkins Bloomberg School of Public Health, comments.

Klag: There is a movement to unmedicalize abortion, that is that there are medications which are on the market in the US and are on the market around the world which can be used to induce abortion. What we’re seeing in the US is that in some states, Alabama, Texas, a huge decrease in the availability of abortion for women and we’re seeing those techniques used in the US as well. It’s done at home, it doesn’t require a trip to what may be a hostile clinic. There needs to be the availability in the rare cases where there are retained products of conception and continued bleeding for medical follow-up.  :32

At Johns Hopkins, I’m Elizabeth Tracey.

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grilled assorted vegetables dressed with extra virgin olive oil

This week’s topics include ultra-long acting insulin, dressed up veggies, lithium during pregnancy, and a new risk factor for cardiovascular disease.

Program notes:

0:38 How veggies are described and consumption
1:35 Indulgent description improved choice
2:46 Education and cardiovascular disease
3:44 42% for those with grad school or professional education
4:45 Need to recognize to treat
5:01 Lithium during pregnancy
6:01 Cardiac malformations in 2.4% of those on lithium
6:37 Ultra long acting insulin
7:47 Compared to long acting only
8:45 Lowers glucose to a lower baseline
9:40 No comparison with cost
10:28 End

Related blog:https://podblog.blogs.hopkinsmedicine.org/2017/06/19/enticing-veggies/

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Anchor lead: How hard will it be to get parents to stop giving fruit juice to babies? Elizabeth Tracey reports

Fruit juice should not be given to infants, the American Academy of Pediatrics has recommended, with amounts for toddlers and older children also sharply reduced. Laura Davis, a pediatric nutrition expert at Johns Hopkins, says this is likely to be a tough change to implement for many parents.

Davis: There are a lot of family traditions and family practices that guide how infants and children are fed in our communities and a lot of that comes from cultural beliefs and preferences. And I think cutting into that is going to be a big, big challenge. A lot of the perception is we did it this way when I was a child so we’re going to continue to do it this way and so it’s a knowledge barrier gap. Trying to address that in a way from an education standpoint and get patients and families buy-in is going to be a big challenge.   :33

Davis notes that older kids especially should be fed the whole fruit rather than juice, since it contains fiber and other nutrients not found in juice. At Johns Hopkins, I’m Elizabeth Tracey.

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