PHARMACY

Study finds children with Type 1 diabetes may have abnormal insulin resistance

BY Michael Johnsen

CHEVY CHASE, Md. According to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism, some children with Type 1 diabetes have been found to have abnormal insulin resistance, The Endocrine Society announced at the top of the month.

Having abnormal insulin resistance appears to negatively affect heart, blood vessel and exercise function in this children with Type 1 diabetes.

In this study, researchers measured insulin sensitivity and heart, blood and exercise function in 12 adolescents with Type 1 diabetes and compared these measurements with measurements from 12 control patients without diabetes, but similar in age, pubertal stage, activity level and body mass index. They found that insulin resistance may affect long-term cardiovascular outcomes in Type 1 diabetes as is found in people with Type 2 diabetes. Specifically, results indicate that insulin resistance is directly related to decreased heart and vessel function and appears to impair capacity to exercise.

“Cardiovascular disease is the major cause of death in adults with diabetes, but until now, little was known about the effects of Type 1 diabetes on cardiovascular health in youth,” stated Kristen Nadeau of the University of Colorado Denver, and lead author of the study. “Our data suggests that while youth with Type 1 diabetes may not present conditions typical of insulin resistance, such as obesity, insulin resistance is present and may affect long-term cardiovascular outcomes in this population.”

“Our study is one of the first definitive studies showing the presence of insulin resistance in youth with Type 1 diabetes and this may have significant implications for the cardiovascular health of these patients,” said Nadeau. “Increasing our understanding of the mechanisms underlying insulin resistance in adolescents with Type 1 diabetes will direct future research and therapeutic interventions. If insulin resistance is addressed early in the care of patients with Type 1 diabetes, it may be possible to decrease cardiovascular morbidity and mortality in this population.”

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Ohio Dept. of Health, retail pharmacies join forces to combat H1N1

BY Michael Johnsen

COLUMBUS, Ohio The Ohio Department of Health on Wednesday announced a public-private partnership with four retail pharmacy chains — Giant Eagle, Kroger, Meijer and Walgreens — to ensure sufficient antiviral medications are available this flu season.

“I’m pleased these retailers have agreed to join us in our effort to help Ohioans as the H1N1 virus continues to cause widespread illness,” stated Alvin Jackson, ODH director. “By putting these plans in place, we can ensure Ohioans will have better access to antiviral medications to treat H1N1 infections even when supplies are limited.”

Ohio is distributing medication from the state stockpile to these chains as needed to address any shortages in the commercial marketplace. The four pharmacies have stores in 70 of Ohio’s 88 counties. In counties where there is no retail presence, Ohio Department of Health will continue to work with local health departments.

In a separate announcement, government health officials announced Friday that vaccines for H1N1 will be available by Dec. 14 to any resident of Ohio who wants them.

 

Any resident of the state can get the vaccine through private physicians, government-approved health centers and local health departments as long as it is available, the state department of health said.

The state government said that it would continue focusing vaccination efforts on high-risk groups, including healthcare workers, pregnant women, people ages 6 months to 24 years, people living with or caring for children younger than 6 months and adults with chronic health conditions. All residents of the state will be able to obtain the vaccine starting Monday, regardless of whether they belong to high-risk groups. Nearly 2.3 million doses of the vaccine are available in the state.

“We continue to urge high-risk Ohioans to seek H1N1 and seasonal flu vaccines,” ODH director Alvin Jackson, M.D said.

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Chain, independent pharmacy lobby backs MTM rider in health-reform bill

BY Jim Frederick

ALEXANDRIA, Va. Chain and independent pharmacy groups are endorsing a new amendment to the Senate’s massive health-reform bill that would boost support for pharmacy-centered medication therapy management programs.

The amendment, sponsored by U.S. Sen. Kay Hagan, D-N.C., would fund improvements and a standardized billing platform for MTM provided to seniors covered by the Medicare Part D drug benefit program. The inclusion of Hagan’s language to the Patient Protection and Affordable Care Act would enable pharmacists “to help more patients take the right medications in the right ways,” noted the National Association of Chain Drug Stores Wednesday.

“Helping patients to understand the importance of taking their medication properly – medication adherence – is a critical way that pharmacists are playing a role in curbing increasing healthcare costs and improving health outcomes for patients,” said NACDS president and CEO Steve Anderson. “We thank Sen. Hagan for her advocacy on behalf of patients and pharmacy – the face of neighborhood healthcare – and we look forward to continuing to work with Congress to help ensure that MTM provisions remain in the final healthcare bill.”

Also endorsing Hagan’s amendment is the National Community Pharmacists Association and its leader, NCPA EVP and CEO Bruce Roberts. MTM programs, the group noted, “have been shown to improve outcomes while lowering healthcare costs.”

Both groups – and their chain and independent pharmacy members – have mounted a sustained lobbying and education campaign to remind lawmakers of the critical and often overlooked role pharmacists can play in delivering more patient-centered and cost-effective health care. If remarks made by Hagan on the Senate floor are any indication, that message appears to be getting through.

“As much as one half of all patients in our country do not follow the doctor’s orders regarding their medications,” Hagan said. Pharmacists, she added, “follow up and educate the patient about his or her medication regimen.”

Two other amendments to the health-reform package also won strong praise from the independent pharmacy group. “NCPA strongly supports an amendment by Sen. Sherrod Brown, D-Ohio, that allows pharmacies to continue providing Durable Medical Equipment, Prosthetics, Orthotics, and Supplies [DMEPOS] and Part B drugs to Medicare beneficiaries without purchasing a surety bond,” Roberts noted. “Like the 14 other types of medical professionals that Medicare exempted from the surety bond requirement, pharmacists are licensed and regulated by the states. Requiring surety bonds is duplicative and may lead to loss of patient access to valuable health care services, such as diabetes testing supplies, canes and crutches.

 “We continue to work with Congress on both a permanent pharmacy exemption from DMEPOS accreditation requirements, as well as an extension of the current moratorium, which is scheduled to expire on Dec. 31, 2009,” added NCPA.

The group also endorsed a rider from Sen. Michael Bennet, D-Colo., that would require the Government Accountability Office to conduct the first detailed study in more than 10 years of pharmacists’ cost of dispensing in the Medicaid program. “Private studies have shown community pharmacists to be compensated well below their cost of dispensing,” said Roberts, “and a GAO study could give Congress and the states needed information for measuring the adequacy of the dispensing fees they pay and the impact upon patient access to pharmacy services.”

In general, he added, “NCPA is grateful for Congress’ bipartisan support of community pharmacy in health care reform and we will continue to work with lawmakers as the legislative process continues.”

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