Pub Date : 2020-01-01DOI: 10.17925/use.2020.16.1.24
Lizheng Shi, R. Hellmund
Objective: Estimate the costs associated with a flash continuous glucose monitoring system as a replacement for self-monitoring of blood glucose (SMBG) for people using intensive insulin to manage diabetes, from a US private payer perspective. Methods: The base case used SMBG at 8 tests/day, the mid-point of the range recommended by the American Diabetes Association for intensive insulin users. Scenario analyses used SMBG at 3, 6 and 10 tests/day. Estimated costs of glucose monitoring and severe hypoglycemic events were assessed. Results: For the base case, the annual cost of SMBG was $4,380 for a patient with type 1 diabetes mellitus (T1DM) compared with $1,712 for flash monitoring, a reduction of $2,667 (61%). The cost of flash monitoring was also lower than SMBG at 6 and 10 tests/day. With SMBG at 3 tests/day the cost was comparable. Similar results were obtained for patients with T2DM using intensive insulin. The annual cost of severe hypoglycemia was approximately 50% less for flash monitoring than for SMBG for both patients with T1DM and those with T2DM. Conclusions: For US private payers, the flash monitoring system provides cost savings compared with SMBG for people with diabetes using intensive insulin. Cost savings with flash glucose monitoring may be realized through a reduction in severe hypoglycemia. Further study of budget impact is needed to include changes in behavior leading to improved adherence.
{"title":"Cost Comparison of Flash Continuous Glucose Monitoring with Self-monitoring of Blood Glucose in Adults with Type 1 or Type 2 Diabetes Using Intensive Insulin—From a US Private Payer Perspective","authors":"Lizheng Shi, R. Hellmund","doi":"10.17925/use.2020.16.1.24","DOIUrl":"https://doi.org/10.17925/use.2020.16.1.24","url":null,"abstract":"Objective: Estimate the costs associated with a flash continuous glucose monitoring system as a replacement for self-monitoring of blood glucose (SMBG) for people using intensive insulin to manage diabetes, from a US private payer perspective. Methods: The base case used SMBG at 8 tests/day, the mid-point of the range recommended by the American Diabetes Association for intensive insulin users. Scenario analyses used SMBG at 3, 6 and 10 tests/day. Estimated costs of glucose monitoring and severe hypoglycemic events were assessed. Results: For the base case, the annual cost of SMBG was $4,380 for a patient with type 1 diabetes mellitus (T1DM) compared with $1,712 for flash monitoring, a reduction of $2,667 (61%). The cost of flash monitoring was also lower than SMBG at 6 and 10 tests/day. With SMBG at 3 tests/day the cost was comparable. Similar results were obtained for patients with T2DM using intensive insulin. The annual cost of severe hypoglycemia was approximately 50% less for flash monitoring than for SMBG for both patients with T1DM and those with T2DM. Conclusions: For US private payers, the flash monitoring system provides cost savings compared with SMBG for people with diabetes using intensive insulin. Cost savings with flash glucose monitoring may be realized through a reduction in severe hypoglycemia. Further study of budget impact is needed to include changes in behavior leading to improved adherence.","PeriodicalId":23490,"journal":{"name":"US endocrinology","volume":"16 1","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67604143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.17925/USE.2020.16.2.80
E. Cox, R. Alicic, Joshua J. Neumiller, K. Tuttle, Spokane Wa Usa Services, Wa Usa Seattle
{"title":"Clinical Evidence and Proposed Mechanisms for Cardiovascular and Kidney Benefits from Glucagon-like Peptide-1 Receptor Agonists","authors":"E. Cox, R. Alicic, Joshua J. Neumiller, K. Tuttle, Spokane Wa Usa Services, Wa Usa Seattle","doi":"10.17925/USE.2020.16.2.80","DOIUrl":"https://doi.org/10.17925/USE.2020.16.2.80","url":null,"abstract":"<p />","PeriodicalId":23490,"journal":{"name":"US endocrinology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67604219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.17925/USE.2020.16.2.97
S. Malik, Southend Fertility, Vasant Vihar New Delhi India Ivf
{"title":"Genital Tuberculosis and its Impact on Male and Female Infertility","authors":"S. Malik, Southend Fertility, Vasant Vihar New Delhi India Ivf","doi":"10.17925/USE.2020.16.2.97","DOIUrl":"https://doi.org/10.17925/USE.2020.16.2.97","url":null,"abstract":"<p />","PeriodicalId":23490,"journal":{"name":"US endocrinology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67604302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.17925/use.2020.16.1.36
L. Gupta, Bhavneet Arora, D. Khandelwal, P. Lal, S. Kalra, S. Bhattacharya, D. Dutta, S. Chittawar, Ankit Paliwal
{"title":"Dietary Practices During Common Religious Fasts in People with Type 2 Diabetes Mellitus Among Different Religions in North India—A Questionnaire-based Study","authors":"L. Gupta, Bhavneet Arora, D. Khandelwal, P. Lal, S. Kalra, S. Bhattacharya, D. Dutta, S. Chittawar, Ankit Paliwal","doi":"10.17925/use.2020.16.1.36","DOIUrl":"https://doi.org/10.17925/use.2020.16.1.36","url":null,"abstract":"<p />","PeriodicalId":23490,"journal":{"name":"US endocrinology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67603686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.17925/USE.2020.16.2.109
Nalini Mahajan, Mother
Extrapulmonary tuberculosis (EPTB) is a complex disease; diagnosis is often difficult due to the paucibacillary status and the invasive procedures required to obtain an adequate sample. Culture testing remains the gold standard for diagnosis, but low bacterial count in EPTB may lead to a negative culture; therefore, a combination of tests is often required for confirmation of diagnosis. Microbiological tests are combined with clinical signs and symptoms, in addition to imaging techniques to improve diagnostic accuracy. Molecular tests have improved time-to-detection for disease and drug sensitivity testing; however, they cannot replace culture testing at present. Though specificity of molecular testing is high, sensitivity varies in samples from different sites, being low for TB meningitis. For genital TB, a combination of tests must be used for timely diagnosis, as disease progression leads to irreversible damage of the reproductive organs. Newer techniques, like whole genome sequencing and next-generation sequencing, are being introduced to improve diagnosis and detect drug resistance. Currently, no single diagnostic test can be considered a ‘point of care’ test. Early and accurate diagnosis is urgently needed to prevent the associated morbidity and mortality.
{"title":"Controversies and Pitfalls in the Diagnosis of Extrapulmonary Tuberculosis with a Focus on Genital Tuberculosis","authors":"Nalini Mahajan, Mother","doi":"10.17925/USE.2020.16.2.109","DOIUrl":"https://doi.org/10.17925/USE.2020.16.2.109","url":null,"abstract":"Extrapulmonary tuberculosis (EPTB) is a complex disease; diagnosis is often difficult due to the paucibacillary status and the invasive procedures required to obtain an adequate sample. Culture testing remains the gold standard for diagnosis, but low bacterial count in EPTB may lead to a negative culture; therefore, a combination of tests is often required for confirmation of diagnosis. Microbiological tests are combined with clinical signs and symptoms, in addition to imaging techniques to improve diagnostic accuracy. Molecular tests have improved time-to-detection for disease and drug sensitivity testing; however, they cannot replace culture testing at present. Though specificity of molecular testing is high, sensitivity varies in samples from different sites, being low for TB meningitis. For genital TB, a combination of tests must be used for timely diagnosis, as disease progression leads to irreversible damage of the reproductive organs. Newer techniques, like whole genome sequencing and next-generation sequencing, are being introduced to improve diagnosis and detect drug resistance. Currently, no single diagnostic test can be considered a ‘point of care’ test. Early and accurate diagnosis is urgently needed to prevent the associated morbidity and mortality.","PeriodicalId":23490,"journal":{"name":"US endocrinology","volume":"16 1","pages":"109"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67603769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.17925/USE.2020.16.2.125
Divya Vundamati, S. Tsai
{"title":"Simultaneous Onset of Autoimmune Hyperthyroidism and Rheumatic Fever in an Adolescent Female—Case Report","authors":"Divya Vundamati, S. Tsai","doi":"10.17925/USE.2020.16.2.125","DOIUrl":"https://doi.org/10.17925/USE.2020.16.2.125","url":null,"abstract":"<p />","PeriodicalId":23490,"journal":{"name":"US endocrinology","volume":"16 1","pages":"125"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67603897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.17925/use.2020.16.1.15
D. Dutta, Soumitra Ghosh, S. Kalra, I. Maisnam, Meha Sharma
1. Department of Endocrinology, Center for Endocrinology Diabetes Arthritis & Rheumatism (CEDAR) Superspecialty Clinics, New Delhi, India; 2. Department of Medicine, Institute of Post Graduate Medical Education & Research (IPGMER), Kolkata, India; 3. Department of Endocrinology, Bharti Hospital, Karmal, India; 4. Department of Endocrinology, RG Kar Medical College, Kolkata, India; 5. Department of Rheumatology, CEDAR Superspecialty Clinics, New Delhi, India
{"title":"Is the Ketogenic Diet an Effective and Safe Approach to Type 2 Diabetes Management and Weight Loss?","authors":"D. Dutta, Soumitra Ghosh, S. Kalra, I. Maisnam, Meha Sharma","doi":"10.17925/use.2020.16.1.15","DOIUrl":"https://doi.org/10.17925/use.2020.16.1.15","url":null,"abstract":"1. Department of Endocrinology, Center for Endocrinology Diabetes Arthritis & Rheumatism (CEDAR) Superspecialty Clinics, New Delhi, India; 2. Department of Medicine, Institute of Post Graduate Medical Education & Research (IPGMER), Kolkata, India; 3. Department of Endocrinology, Bharti Hospital, Karmal, India; 4. Department of Endocrinology, RG Kar Medical College, Kolkata, India; 5. Department of Rheumatology, CEDAR Superspecialty Clinics, New Delhi, India","PeriodicalId":23490,"journal":{"name":"US endocrinology","volume":"16 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67604086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.17925/use.2020.16.1.47
Martin J. Rutkowski, D. Southwell, T. Cardinal, L. Blevins
McCune–Albright syndrome (MAS) is characterized by polyostotic fibrous dysplasia, café-au-lait hyperpigmentation of the skin, and acromegaly. Ablative therapy in affected patients must target the entire pituitary gland, making medical management the preferred therapy. Targeted medical therapies, including somatostatin and growth hormone (GH) receptor blockade, have shown promise in achievement of biochemical remission. We present the case of a 15-year-old girl with MAS who was discovered to have pituitary enlargement on computed tomography scan. She presented with café-au-lait spots, fibrous dysplasia of the sphenoid bone, and elevated insulin-like growth factor 1 and GH levels that failed to suppress on oral glucose tolerance testing. Treatment with a somatostatin analog was shown to be a safe and effective long-term management strategy of acromegaly that provides advantages over surgical resection.
{"title":"Acromegaly Due to McCune–Albright Syndrome","authors":"Martin J. Rutkowski, D. Southwell, T. Cardinal, L. Blevins","doi":"10.17925/use.2020.16.1.47","DOIUrl":"https://doi.org/10.17925/use.2020.16.1.47","url":null,"abstract":"McCune–Albright syndrome (MAS) is characterized by polyostotic fibrous dysplasia, café-au-lait hyperpigmentation of the skin, and acromegaly. Ablative therapy in affected patients must target the entire pituitary gland, making medical management the preferred therapy. Targeted medical therapies, including somatostatin and growth hormone (GH) receptor blockade, have shown promise in achievement of biochemical remission. We present the case of a 15-year-old girl with MAS who was discovered to have pituitary enlargement on computed tomography scan. She presented with café-au-lait spots, fibrous dysplasia of the sphenoid bone, and elevated insulin-like growth factor 1 and GH levels that failed to suppress on oral glucose tolerance testing. Treatment with a somatostatin analog was shown to be a safe and effective long-term management strategy of acromegaly that provides advantages over surgical resection.","PeriodicalId":23490,"journal":{"name":"US endocrinology","volume":"16 1","pages":"47"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67603705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.17925/USE.2019.15.1.39
Theresa R. Tonozzi, A. Kammesheidt, G. Braunstein, Independent Researcher
{"title":"Liquid Biopsies in Endocrine Neoplasia—A Systematic Review","authors":"Theresa R. Tonozzi, A. Kammesheidt, G. Braunstein, Independent Researcher","doi":"10.17925/USE.2019.15.1.39","DOIUrl":"https://doi.org/10.17925/USE.2019.15.1.39","url":null,"abstract":"<p />","PeriodicalId":23490,"journal":{"name":"US endocrinology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67603476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.17925/USE.2019.15.1.10
Donna Ryan
{"title":"Forging a New Path for Diabetes Care","authors":"Donna Ryan","doi":"10.17925/USE.2019.15.1.10","DOIUrl":"https://doi.org/10.17925/USE.2019.15.1.10","url":null,"abstract":"<p />","PeriodicalId":23490,"journal":{"name":"US endocrinology","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67603276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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