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ANCHOR LEAD: INTENSIVE MANAGEMENT DOESN’T HELP AVOID CARDIOVASCULAR EVENTS IN THOSE WITH DIABETES, ELIZABETH TRACEY REPORTS
People with diabetes are at increased risk for heart attack, stroke, and other adverse outcomes. A large NIH sponsored study begun over a decade ago aimed to determine if intensive management of risk factors could reduce their incidence. Rita Kalyani, a diabetes expert at Johns Hopkins, describes the results.
KALYANI: This study was designed to test the hypothesis that an intensive intervention could affect cardiovascular risk factors and ultimately reduce cardiovascular events. In this interim analysis patients had been followed for up to 11 years and what they found was that although previous analyses done at shorter intervals demonstrated benefits on sleep patterns, on need for medications, in those who were in the intensive arm. After this duration of follow up, which was up to 11 years, there was no significantly decreased risk of cardiovascular events, and this was a surprising finding. :33
Kalyani says that those in the intensive management group did need fewer medications, however. At Johns Hopkins, I’m Elizabeth Tracey.
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ANCHOR LEAD: HOW MUCH CAN BEANS HELP KEEP BLOOD SUGAR UNDER CONTROL FOR THOSE WITH DIABETES? ELIZABETH TRACEY REPORTS
If you really like legumes like beans and lentils, they may help keep your blood sugar under control if you have diabetes, but are not so good that people should strive to make a switch to them from whole grains. That’s the conclusion of a new study, and Rita Kalyani, a diabetes expert at Johns Hopkins, says the diet and diabetes relationship is complex.
KALYANI: Low glycemic foods can certainly be a part of that but they are not the only part of that. So it’s important to have a balanced diet of carbohydrates, proteins and fat. We say to moderate carbohydrates, not restrict them because it is important to have it for energy and metabolism. Also saturated versus trans fat is also important to keep those in mind. Having a healthy intake of fiber, moderating alcohol consumption, moderating sugarYsweetened beverage consumption, all of these factors go into a healthy diet. :28
Kalyani adds that factors such as exercise must also be considered for blood sugar control. At Johns Hopkins, I’m Elizabeth Tracey.
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Program notes:
0:16 The population needing joint surgery has grown exponentially
1:01 Now we have good research showing that earlier is better
2:08 They need to meet some criteria to be a candidate
3:12 Many patients want both knees done at the same time
4:12 Our length of stay has really improved dramatically
5:04 We've improved techniques, less tissue damage, faster range of motion recovery
6:05 Do through three to five inch incisions, sneak in through the side
7:01 Hip resurfacing saves bone
8:02 May or may not need conversion to a total replacement later
9:02 We will take away their pain, give them their life back
9:56 End
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ANCHOR LEAD: ARE BEANS BETTER THAN BREAD FOR FOLKS WITH DIABETES? ELIZABETH TRACEY REPORTS
Keeping blood sugar under control is a big responsibility for those with diabetes, and diet can help. Now a new study compares whether legumes such as beans and lentils are more helpful than whole grains. Rita Kalyani, a diabetes expert at Johns Hopkins, comments.
KALYANI: We often refer our patients with diabetes to see a dietician and the dieticians will give dietary modification advice. Whole wheat may be part of the thing that they recommend. If you take in small amounts versus larger amounts you might expect to see a different effect on blood glucose. I think the authors were being conservative in comparing the legumes to whole wheat. They wanted to see whether the legumes were able to offer any additional benefit compared to the whole wheat and I think that is a strength of this study, however the benefit was modest. :28
Kalyani says this study likely illustrates that people can choose when it comes to whole grains or beans, and that variety is probably a good thing. At Johns Hopkins, I’m Elizabeth Tracey.
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ANCHOR LEAD: A WHOLE NEW COMMITMENT TO PRIMARY CARE IS NEEDED UNDER THE AFFORDABLE CARE ACT, ELIZABETH TRACEY REPORTS
Primary care medicine is likely to come more sharply into focus as the Affordable Care Act is implemented and millions of people who’ve never had health insurance are now able to access medical care. How will an academic medical center such as Johns Hopkins help answer this need? Paul Rothman, dean of the Johns Hopkins School of Medicine, comments.
ROTHMAN: Part of the solution to this would be utilizing mid-level providers, that’s nurse practitioners, that’s physician assistants, and others, to take care of these primary care population that we otherwise don’t have the physician workforce to take care of, and so that means you develop teams, where physicians, nurses, PAs and others work together as a team to take care of people, and I think that at Hopkins we’re hoping to help build those teams. :26
Rothman says that primary care specialties are likely to become more attractive to medical students as reimbursement will also change under the Affordable Care Act. At Johns Hopkins, I’m Elizabeth Tracey.
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ANCHOR LEAD: COST EFFECTIVE HEALTHCARE MAY GET A BOOST UNDER HEALTHCARE REFORM, ELIZABETH TRACEY REPORTS
No matter where you sit on the matter of healthcare reform, one thing is clear: costs must be kept under control, but not at the expense of quality. Paul Rothman, dean and CEO of Johns Hopkins Medicine, says one piece of the Affordable Care Act, recently upheld by the Supreme Court, may help.
ROTHMAN: One of the other really important parts of the bill are the innovative grants that the bill is going to provide. We know it’s important moving forward that we’re able to develop systems of cost-efficient healthcare that’s still is very patient centered, highest quality and safe care. Part of the bill allows for innovative programs to try to develop care systems that do all that, and so at Johns Hopkins and other academic medical centers in the country we’re very excited about the opportunity to use some of these funds to develop ways to take much better care of patients. :34
At Johns Hopkins, I’m Elizabeth Tracey.
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ANCHOR LEAD: WHAT WILL THE SUPREME COURT’S DECISION ON HEALTHCARE REFORM MEAN TO YOU? ELIZABETH TRACEY REPORTS
The Supreme Court has rendered its longQawaited decision largely upholding healthcare reform as proposed by the Obama administration. Paul Rothman, dean and CEO of Johns Hopkins Medicine, says now it’s time to get to work.
ROTHMAN: I think it’s really important the Supreme Court made a decisive decision on Healthcare Reform Act. Now that we have certainty I think everyone feels much more comfortable going forward in planning for what healthcare is going to look like in the future. :15
Rothman applauds some aspects of the legislation.
ROTHMAN: Increased coverage for up to 32 million Americans, protection for people who have pre-existing conditions, insuring that if you have children 26 and under, they can have insurance under your policy, so there are a lot of wonderful parts to the bill that we’re glad have been approved. :18
Rothman welcomes the opportunity to help create a more patient-centered, cost-effective system of healthcare. At Johns Hopkins, I’m Elizabeth Tracey.
