Advertisement
Taking a Proactive Approach to Diabetic Neuropathy

Taking a Proactive Approach to Diabetic Neuropathy

According to recent estimates, diabetic neuropathy accounts for about $50 billion in both direct and indirect costs associated with diabetes in the United States. “Diabetic neuropathy is one of the most common microvascular complications of diabetes,” says Cecilia C. Low Wang, MD, FACP. “It’s associated with major morbidity and can significantly reduce quality of life for patients.” Diabetic neuropathy occurs in about 60% of patients with diabetes at some point during their lifetime and is more common in those living with diabetes for a number of years. The condition is characterized by impairment of peripheral nerve axons, particularly in the limbs. Diabetic neuropathy often results from chronic hyperglycemia, regardless of the type of diabetes. There are several different types of neuropathy that patients with diabetes may experience, but the most common forms are distal symmetric or sensorimotor diabetic peripheral neuropathy (DPN) and autonomic neuropathy. With DPN, patients typically describe their symptoms as tingling, pain, numbness, or weakness that starts out in the feet and progresses to the hands at a much later stage. With autonomic neuropathy, orthostatic hypotension, blood pressure dysregulation, urinary retention, erectile dysfunction, and gastroparesis are among the clinical consequences of autonomic dysfunction. There can also be significant hypoglycemia unawareness. Diagnostic Considerations “Early recognition and appropriate management of neuropathy in patients with diabetes are important,” says Dr. Low Wang. She notes that a number of treatment options are available for symptoms of DPN but adds that these therapies do not treat the underlying mechanisms of the disease. The American Diabetes Association notes that up to 50% of DPN cases may be asymptomatic. These patients are at risk...

Social Media Tips for Doctors

Recently, I was asked for personal advice on using Twitter. There are many articles out there that say we (physicians) don’t know how to properly use social media. Social media can be a very powerful tool in medicine. It can not only help us get medical information out there to our patients, but it can also help us connect with people, colleagues, and organizations to give us more visibility—whether for career advancement, media contacts, or just to get our voices heard. Social Media Basics: These are some of the tips I have come up with for doctors who want to take advantage of the many opportunities social media can offer: 1. Never communicate to patients through social media outlets. It is a set up for disaster and HIPAA violations. 2. Social media can be used for educating patients. Patients can follow you on these pages to get information about your practice and whatever medical information you wish to share. Twitter… 3.  Twitter is useful for growing your professional connections. It can be leveraged so you get known and also connect with other doctors, healthcare information technology people, media, etc. Patients can follow you on Twitter, but it generally is not a useful method of providing patient information because tweets are limited to 140 characters. 4. Choose your followers carefully. Block those who spam or troll you (“trolls” are people who negatively post with the deliberate intent of provoking a reaction). Many people will try to sell you things. Monitor your account because it is not uncommon for it to be hacked. 5. Grow your network. Have a group that...
Physical Activity Assessment Guide

Physical Activity Assessment Guide

Despite the well-established benefits of leading a physically active lifestyle, many adults in the United States are not physically active enough. “There is a need for routine and consistent assessment of physical activity in research and clinical settings in patients with cardiovascular disease (CVD),” says Scott J. Strath, PhD. “Such assessments may improve the identifica­tion of risk factors, minimize physical inactivity, and further advance our understanding of the health-related impact.” Guidance Issued In 2013, the American Heart Association (AHA) released a scientific statement on assessing physical activity. “The objectives of the AHA statement were to provide the rationale for assessing physical activity, explain the key concepts involved in making these assessments, and offer a roadmap on how to conduct these assessments,” says Dr. Strath, who was lead author of the AHA statement. “Most providers have not routinely assessed physical activity levels because they haven’t had the right tools.” “Clinicians should be performing physical activity assessments as part of routine medical care along with the other classic risk factors for these diseases.” The AHA scientific statement features a decision matrix to help providers select the most appropriate assessment method. The matrix includes low-cost or no-cost options, such as questionnaires that patients complete when they arrive for their appointment. “Several issues need to be considered when deciding on ways to assess physical activity levels,” Dr. Strath says. “These include feasibility and practicality of assessments, the availability of resources, and administrative considerations.” The AHA’s decision matrix provides a mechanism for this selection that takes into account all of these factors. The adopted assessment method will vary depending on circumstances because there is...
Get Connected

Get Connected

Get the edge on your colleagues by receiving updates directly from the Physician’s Weekly editors in multiple ways. Sign up for our weekly e-newsletter Subscribe to our RSS Feed Like us on Facebook Check us out on Google+ Follow us on Twitter Join the conversation on...
[ HIDE/SHOW ]