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April 2014 Briefing - Diabetes & Endocrinology

Here are what the editors at HealthDay consider to be the most important developments in Diabetes & Endocrinology for April 2014. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Established Modifiable Factors Account for Half of Strokes

WEDNESDAY, April 30, 2014 (HealthDay News) -- Established causal and modifiable factors, including hypertension and smoking, account for about half of all strokes, according to a study published online April 29 in PLOS Medicine.

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Afternoon Exercise May Up Overnight/Next-Day Hypoglycemia

WEDNESDAY, April 30, 2014 (HealthDay News) -- Afternoon moderate-to-vigorous physical activity (MVPA) increases the risk of overnight and next-day hypoglycemia in adolescents with type 1 diabetes, according to research published in the May issue of Diabetes Care.

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Meta-Analysis: Vitamin D Does Not Cut Falls by ≥15 Percent

TUESDAY, April 29, 2014 (HealthDay News) -- Vitamin D supplementation, with or without calcium, does not reduce the risk of falls by 15 percent or more, according to a trial sequential meta-analysis published online April 24 in The Lancet Diabetes & Endocrinology.

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Aspirin Use Cuts CRC Risk With High 15-PGDH Expression

TUESDAY, April 29, 2014 (HealthDay News) -- Regular aspirin use is associated with a reduced risk of colorectal cancer in association with high hydroxyprostaglandin dehydrogenase 15-(nicotinamide adenine dinucleotide) (15-PGDH) expression, according to a study published in the April 23 issue of Science Translational Medicine.

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Drinking More Coffee May Cut Risk of Type 2 Diabetes

TUESDAY, April 29, 2014 (HealthDay News) -- Increasing coffee consumption may lower the risk of developing type 2 diabetes, according to research published online April 24 in Diabetologia.

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BMI Linked to Coronary Plaque in Asymptomatic Diabetes

MONDAY, April 28, 2014 (HealthDay News) -- For asymptomatic patients with diabetes, body mass index (BMI) is directly related to coronary plaque, as measured by coronary computed tomography (CT) angiography, according to a study published online April 22 in Radiology.

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For Statin Users, Caloric, Fat Intake Up Since 1999 to 2000

FRIDAY, April 25, 2014 (HealthDay News) -- For statin users, but not nonusers, caloric and fat intake increased significantly from 1999-2000 to 2009-2010, according to a study published online April 24 in JAMA Internal Medicine.

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Serum Marker Predicts Cardiovascular Events in Diabetes

FRIDAY, April 25, 2014 (HealthDay News) -- Elevated levels of polyclonal serum immunoglobulin combined free light chains (cFLCs) may indicate adverse cardiovascular disease (CVD) outcomes in patients with type 2 diabetes, according to research published online April 17 in Diabetes Care.

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Physician Groups Find Fault With Medicare Payment Data Release

THURSDAY, April 24, 2014 (HealthDay News) -- Physician groups cite major problems associated with the release of Medicare payment data, according to an article published April 16 in Medical Economics.

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Out-of-Pocket Costs Decline for Patients With Diabetes

THURSDAY, April 24, 2014 (HealthDay News) -- During the past decade, out-of-pocket (OOP) costs have declined for individuals with diabetes, according to research published online March 25 in Diabetes Care.

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Educational Changes Suggested for Patient-Centered Medicine

THURSDAY, April 24, 2014 (HealthDay News) -- Changes in medical education and training are suggested to help new physicians address the needs of patients and their families, according to an ideas and opinions piece published in the April 22 issue of the Annals of Internal Medicine.

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Frequency of Arrhythmia Up in Nocturnal Hypoglycemia

WEDNESDAY, April 23, 2014 (HealthDay News) -- For insulin-treated patients with type 2 diabetes, nocturnal hypoglycemia is associated with increased frequency of arrhythmia, according to a study published in the May issue of Diabetes.

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FDA Proposes Accelerated Medical Device Approval Plan

WEDNESDAY, April 23, 2014 (HealthDay News) -- The U.S. Food and Drug Administration has proposed a new program that would provide expedited access to high-risk medical devices intended for patients with serious conditions whose medical needs are not met by current technology.

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Vitamin D Levels Linked to Activity Level in Severely Obese

WEDNESDAY, April 23, 2014 (HealthDay News) -- Among the severely obese, vitamin D status is related to physical activity and physical function, according to research published online April 15 in the Journal of Clinical Endocrinology & Metabolism.

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Obstructive Sleep Apnea Linked to Osteoporosis

TUESDAY, April 22, 2014 (HealthDay News) -- Obstructive sleep apnea (OSA) is associated with an increased risk of osteoporosis, according to a study published online April 15 in the Journal of Clinical Endocrinology & Metabolism.

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Lipid Genes Have Pleiotropic Impact on Glucose-Linked Traits

TUESDAY, April 22, 2014 (HealthDay News) -- Genetic predisposition to dyslipidemia has a pleiotropic lowering effect on glucose-related traits, according to a study published online April 10 in Diabetes.

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Low Glucose Tied to Higher Aggressive Impulses, Behavior

TUESDAY, April 22, 2014 (HealthDay News) -- Glucose levels may be tied to aggressive impulses and behaviors in married couples, according to a study published online April 14 in the Proceedings of the National Academy of Sciences.

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Abridged Food Education Program for Children Still Helpful

TUESDAY, April 22, 2014 (HealthDay News) -- An abbreviated version of the Nutrition Detectives Program improves students' food-label literacy, according to a study published online April 10 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Task Force Recommends Ways to Improve Price Transparency

MONDAY, April 21, 2014 (HealthDay News) -- Price transparency frameworks, which provide price information presented in the context of other relevant information, should be developed to meet patients' needs, according to recommendations presented in a report from the Healthcare Financial Management Association (HFMA).

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Primary Care Doctors Must Influence Lifestyle Changes

MONDAY, April 21, 2014 (HealthDay News) -- Primary care physicians (PCPs) are increasingly called upon to manage circulatory and circulatory-related diseases among their patients, according to an article published April 10 in Medical Economics.

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High Total, Animal Protein Intake Ups Type 2 Diabetes Risk

MONDAY, April 21, 2014 (HealthDay News) -- High total and animal protein intake correlates with increased incidence of type 2 diabetes, according to a study published online April 10 in Diabetes Care.

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AMA Examines Economic Impact of Physicians

FRIDAY, April 18, 2014 (HealthDay News) -- Physicians who mainly engage in patient care contribute a total of $1.6 trillion in economic output, according to the American Medical Association (AMA)'s Economic Impact Study.

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Int'l Medical Education Standards Not Equivalent to U.K. Standards

FRIDAY, April 18, 2014 (HealthDay News) -- International medical graduates passing the Professional and Linguistic Assessments Board (PLAB) of the General Medical Council (GMC) have lower performance on MRCP(UK) (Membership of the Royal Colleges of Physicians) and MRCGP (Membership of the Royal College of General Practitioners) and on annual review of competence progression (ARCP) examinations, according to two studies published online April 17 in BMJ.

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Trust in Provider Improves Antidepressant Adherence in DM

FRIDAY, April 18, 2014 (HealthDay News) -- Patients with diabetes who lack trust and shared decision-making with their providers are less likely to be adherent to antidepressant therapy for depression, according to research published online April 5 in the Journal of General Internal Medicine.

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White House: 8 Million People Signed Up for Health Insurance

FRIDAY, April 18, 2014 (HealthDay News) -- Eight million Americans signed up for private health insurance during the just-concluded first enrollment period under the Affordable Care Act, the White House announced Thursday afternoon.

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One in 20 U.S. Adults a Victim of Diagnostic Errors

THURSDAY, April 17, 2014 (HealthDay News) -- Diagnostic errors affect at least one in 20 U.S. adults, according to research published online April 17 in BMJ Quality & Safety.

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GLP-1 Slows Hypoglycemia-Induced Gastric Emptying

THURSDAY, April 17, 2014 (HealthDay News) -- For healthy subjects, exogenous glucagon-like peptide 1 (GLP-1) attenuates hypoglycemia-induced acceleration of gastric emptying, according to a study published online March 5 in Diabetes Care.

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Patient-Clinician Relationship Impacts Health Care Outcomes

THURSDAY, April 17, 2014 (HealthDay News) -- The patient-clinician relationship has a small but significant effect on health care outcomes, according to a study published online April 9 in PLOS ONE.

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Educator Discusses Key Issues for Future Doctors to Consider

THURSDAY, April 17, 2014 (HealthDay News) -- The key issues for future physicians are discussed in an article published by the American Medical Association (AMA).

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Diabetes-Related Complications Declined, 1990 to 2010

WEDNESDAY, April 16, 2014 (HealthDay News) -- Rates of diabetes-related complications have declined substantially over the past two decades, according to a study published in the April 17 issue of the New England Journal of Medicine.

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Prevalence of Diabetes Has Skyrocketed in the U.S.

WEDNESDAY, April 16, 2014 (HealthDay News) -- During the past two decades, the prevalence of diabetes in the United States has increased substantially, according to research published in the April 15 issue of the Annals of Internal Medicine.

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Graves Disease Incidence Varies by Race

WEDNESDAY, April 16, 2014 (HealthDay News) -- Graves disease is more common in blacks and Asian/Pacific Islanders compared with whites, according to a research letter published in the April 16 issue of the Journal of the American Medical Association.

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Continued Reliance on Windows XP May Threaten Data Security

WEDNESDAY, April 16, 2014 (HealthDay News) -- Physicians who use Windows XP in their practices may be affected by Microsoft's recent discontinuation of support for the program, according to an article published April 8 in Medical Economics.

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FDA Approves Tanzeum for Type 2 Diabetes

TUESDAY, April 15, 2014 (HealthDay News) -- Tanzeum (albiglutide) has been approved by the U.S. Food and Drug Administration to help control blood glucose, along with diet and exercise, in adults with type 2 diabetes.

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Patients Paying Much More for Specialty Drugs

TUESDAY, April 15, 2014 (HealthDay News) -- Many Americans are paying less for prescription drugs, but some are having to deal with sharp rises in the cost of specialty medicines for rare or serious diseases, according to a new report.

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Fewer Ophthalmologists Equals Less Diabetic Eye Care

TUESDAY, April 15, 2014 (HealthDay News) -- In areas with less access to ophthalmologists, fewer individuals with diabetes, diabetic retinopathy, and age-related macular degeneration (ARMD) receive care, according to a study published in the April issue of JAMA Ophthalmology.

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Intensive Insulin Rx Lowers Glycemic Variability in Early DM

TUESDAY, April 15, 2014 (HealthDay News) -- Short-term intensive insulin therapy (IIT) can improve β-cell function in type 2 diabetes mellitus (T2DM) in association with decreased glycemic variability, according to a study published in the April issue of Diabetes Care.

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New Health Secretary to Confront Health Care Reform Hurdles

MONDAY, April 14, 2014 (HealthDay News) -- With the resignation of U.S. Health and Human Services Secretary Kathleen Sebelius on Friday, the Affordable Care Act will get a fresh face. But turning around public perception of the controversial health care reform law in a politically charged mid-term election year poses an enormous challenge for the department's next leader, policy experts said.

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Sebelius Stepping Down As HHS Secretary

FRIDAY, April 11, 2014 (HealthDay News) -- U.S. Health and Human Services Secretary Kathleen Sebelius is stepping down from her position, after overseeing the troubled rollout of the Affordable Care Act that remains unpopular with some Americans and virtually all Republican lawmakers.

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Blood Glucose Levels Set for Achieving HbA1c Targets

FRIDAY, April 11, 2014 (HealthDay News) -- The average self-monitored blood glucose (SMBG) concentrations needed at premeal, postmeal, and bedtime have been established to achieve a range of hemoglobin A1c (HbA1c) targets, according to research published in the April issue of Diabetes Care.

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Parents Feel Limited in Ability to Prevent Child Obesity

FRIDAY, April 11, 2014 (HealthDay News) -- Parents want to help their children avoid obesity but feel limited in their ability to take action, according to a study published online April 3 in the U.S. Centers for Disease Control and Prevention's Preventing Chronic Disease.

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Prevalence of Childhood Obesity in U.S. Up From 1999

THURSDAY, April 10, 2014 (HealthDay News) -- From 1999, all classes of obesity have increased in children, although the rates in 2011 to 2012 were not significantly different from those in 2009 to 2010, according to a study published online April 7 in JAMA Pediatrics.

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Fewer Americans Overwhelmed by Medical Bills

WEDNESDAY, April 9, 2014 (HealthDay News) -- While millions of Americans still feel hamstrung by medical expenses, a new government report shows that some people are getting relief.

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More Justification Needed for Choosing Wisely Selections

WEDNESDAY, April 9, 2014 (HealthDay News) -- Most services included in specialty medical societies' Top 5 lists for the Choosing Wisely campaign are based on evidence demonstrating equivalent but not superior benefit, with higher risk or higher costs compared to other options, according to a research letter published in the April 9 issue of the Journal of the American Medical Association.

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Obese Child Incurs Extra $19,000 Lifetime Medical Costs

WEDNESDAY, April 9, 2014 (HealthDay News) -- The incremental lifetime medical cost of an obese child compared to a normal-weight child who maintains normal weight throughout adulthood is roughly $19,000, according to a study published online April 7 in Pediatrics.

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Some Doctors Paid at Least $3 Million Each by Medicare

WEDNESDAY, April 9, 2014 (HealthDay News) -- A small number of doctors received at least $3 million each in Medicare payments in 2012, for a total of nearly $1.5 billion, according to an analysis of Medicare claims data released Wednesday by the White House. In total, Medicare paid individual physicians nearly $64 billion in 2012. The median payment was just over $30,000, the Associated Press reported.

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Nonalcoholic Fatty Liver Disease Linked to CKD in T1DM

WEDNESDAY, April 9, 2014 (HealthDay News) -- For patients with type 1 diabetes, nonalcoholic fatty liver disease (NAFLD) is independently associated with the risk of incident chronic kidney disease (CKD), according to a study published online April 2 in Diabetes Care.

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Lifestyle Intervention Provides Lasting Benefits in IGT

TUESDAY, April 8, 2014 (HealthDay News) -- For adults with impaired glucose tolerance, a six-year lifestyle intervention program reduces cardiovascular and all-cause mortality, and diabetes, according to a study published online April 3 in The Lancet Diabetes & Endocrinology.

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NCQA Updates Recognition Standards for Medical Homes

TUESDAY, April 8, 2014 (HealthDay News) -- The National Committee for Quality Assurance (NCQA) has updated its guidelines for patient-centered medical homes, according to an article published March 27 in Medical Economics.

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Newly Eligible for Expanded Medicaid Are Healthier

MONDAY, April 7, 2014 (HealthDay News) -- Persons newly eligible for expanded Medicaid coverage under the Affordable Care Act (ACA) are not sicker than pre-ACA enrollees, according to research published online March 26 in Health Affairs.

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U-Shaped Association for Sodium Intake, Mortality

MONDAY, April 7, 2014 (HealthDay News) -- Low and high sodium intake are associated with increased mortality, according to a meta-analysis published online March 20 in the American Journal of Hypertension.

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Vitamin D Supplementation May Be Beneficial in Depression

MONDAY, April 7, 2014 (HealthDay News) -- Vitamin D supplementation has no overall effect on depressive symptoms, but may have a significant effect for those with clinically significant depression, according to a review published online March 14 in Psychosomatic Medicine.

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Patients Select Fewer New Docs at Bottom of Tiered Ranking

MONDAY, April 7, 2014 (HealthDay News) -- Patients are less likely to select a new physician ranked in the bottom of a tiered network, but often don't switch if their current physician is ranked at the bottom, according to research published online March 11 in Health Services Research.

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Calorie Restriction Aids Aging in Primates; Contradicts Earlier Data

FRIDAY, April 4, 2014 (HealthDay News) -- Calorie restriction (CR) may provide aging-related benefits, including a reduction in all-cause mortality, according to an animal study published online April 1 in Nature Communications.

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AMA Provides Resources to Aid Physicians' Collections

FRIDAY, April 4, 2014 (HealthDay News) -- The American Medical Association (AMA) has released resources to help doctors confront policy jumpers who may pose a financial risk to physicians during the Affordable Care Act's 90-day premium grace period, according to an article published March 25 in Medical Economics.

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Maternal Insulin Sensitivity Linked to Fetal Brain Activity

FRIDAY, April 4, 2014 (HealthDay News) -- Maternal insulin sensitivity is associated with fetal brain responses, according to a study published in the online March 25 in Diabetologia.

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Anti-Inflammatory Benefits for CKD Seen With Walking

FRIDAY, April 4, 2014 (HealthDay News) -- Exercise may be an effective anti-inflammatory therapy in pre-dialysis patients with chronic kidney disease (CKD), according to a study published online April 3 in the Journal of the American Society of Nephrology.

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Interarm BP Difference May Up Cardiac Risk in Diabetes

THURSDAY, April 3, 2014 (HealthDay News) -- Interarm differences in systolic blood pressure (BP) in patients with diabetes may be associated with an increased risk of cardiovascular morbidity and mortality, according to research published online on March 25 in Diabetes Care.

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Half of Uninsured Don't Intend to Sign Up for Health Coverage

WEDNESDAY, April 2, 2014 (HealthDay News) -- About 50 percent of uninsured adults do not intend to sign up for coverage through the Affordable Care Act's health care exchanges, according to an article published March 26 in Medical Economics.

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Lack of Clear Evidence for Health Benefits of Vitamin D

WEDNESDAY, April 2, 2014 (HealthDay News) -- Evidence is lacking for the associations between vitamin D and health outcomes, according to one review published April 1 in BMJ; however, lower levels of circulating 25-hydroxyvitamin D correlate with increased mortality, according to another review also published April 1 in BMJ.

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ACEIs, Not ARBs, Reduce Cardiac Mortality in Diabetes

WEDNESDAY, April 2, 2014 (HealthDay News) -- For patients with diabetes mellitus (DM), angiotensin-converting enzyme inhibitors (ACEIs), but not angiotensin II receptor blockers (ARBs), reduce all-cause and cardiovascular (CV) mortality, according to research published online March 31 in JAMA Internal Medicine.

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Seven+ Daily Portions of Fruit, Vegetables Cut Mortality

WEDNESDAY, April 2, 2014 (HealthDay News) -- Fruit and vegetable consumption is associated with reduced mortality, with benefits seen for consumption of seven or more portions per day, according to a study published online March 31 in the Journal of Epidemiology & Community Health.

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CMS: Medicare Beneficiaries Saved $3.9B on Meds in 2013

TUESDAY, April 1, 2014 (HealthDay News) -- In 2013, 4.3 million seniors and people with disabilities saved an estimated $3.9 billion on prescription drugs, an increase from the 2012 savings, according to a report published by the U.S. Department of Health and Human Services.

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Adverse Cardiometabolic Profile With Postpartum Weight Gain

TUESDAY, April 1, 2014 (HealthDay News) -- Women who do not lose weight between three and 12 months after pregnancy have an adverse cardiometabolic profile, according to a study published online March 25 in Diabetes Care.

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Nearly One-Third of Initial Prescriptions Remain Unfilled

TUESDAY, April 1, 2014 (HealthDay News) -- A sizable number of patients fail to fill their initial drug prescriptions, according to research published in the April 1 issue of the Annals of Internal Medicine.

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Physician's Briefing