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Diabetic Kidney Disease: Coming to a Consensus

Diabetic Kidney Disease: Coming to a Consensus

As the incidence and prevalence of type 2 diabetes have grown, there has also been an increase in the number of people developing diabetic kidney disease (DKD) and end-stage renal disease (ESRD). “Diabetes is the leading cause of ESRD, accounting for almost 50% of cases,” says Mark E. Molitch, MD. Incidence rates for ESRD have stabilized over the past few years, but differences remain among high-risk subgroups, including middle-aged African Americans, Native Americans, and Hispanics. The healthcare disparities may be partially due to increasing rates of obesity and diabetes among younger people from these populations. Research has shown that the overall costs of care for people with DKD are extraordinarily high, due in large part to the strong relationship of DKD with cardiovascular disease (CVD) and the development of ESRD. In 2011, overall Medicare expenditures for diabetes and chronic kidney disease (CKD) in people aged 65 and older were approximately $25 billion. As patients transition to ESRD, studies have shown that the per-person per-year costs are $20,000 for those covered by Medicare and $40,000 for patients younger than 65. Importantly, much of the excess CVD resulting from diabetes is accounted for by people with DKD. Addressing Vital Issues In 2014, the Consensus Conference on Chronic Kidney Disease and Diabetes was convened by the American Diabetes Association in collaboration with the American Society of Nephrology and the National Kidney Foundation because of the high human and societal costs associated with DKD. “The consensus report addresses vital issues regarding patient care,” says Dr. Molitch, who co-chaired the consensus group. It highlights current practices, gaps in knowledge, and new directions for improving...
Life Expectancy in 2013

Life Expectancy in 2013

Life expectancy at birth represents the average number of years that a group of infants would live if the group was to experience throughout life the age-specific death rates present for their year of...
Is There A Mental Healthcare Crisis In The U.S.?

Is There A Mental Healthcare Crisis In The U.S.?

We are all shocked when we see news stories of multiple people being killed by someone who seems to have gone off the deep end. While these events are extremely rare, it is a true tragedy to have them happen at all. It is often found that the guilty parties were suffering from some mental illness. These are the extremes of mental illness. However, milder forms of mental illness, such as anxiety and depression are very prevalent in the U.S. The unfortunate reality is that for many of these patients, they just cannot get mental healthcare even if they want access to it. How big is the problem? According to a survey of physicians on Sermo, the number one social network exclusively for physicians, approximately 84% of the doctors polled believe there is a mental healthcare crisis in this country. Often times, the primary care physician is left to care for these patients whom they may not feel comfortable taking care of, just because they cannot get an appointment for the patient with a psychiatrist. I often times have a patient who I believe needs to see a psychiatrist but is unable to get an appointment for up to 6 months. If a patient is having a mental healthcare urgency, they usually end up in the ER for lack of access to outpatient healthcare. But, psychiatrists are not to blame. This is rather due to a broken system that is in need of major reforms. Why is there a mental healthcare access crisis in the U.S.? 1. In the 1960’s, psychiatric hospitals closed their doors, making inpatient services very...
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