American Association of Clinical Endocrinologists, May 23-27, 2012

The American Association of Clinical Endocrinologists' 21st Annual Scientific and Clinical Congress

The annual meeting of the American Association of Clinical Endocrinologists (AACE) was held from May 23 to 27 in Philadelphia and attracted approximately 17,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in endocrinology. The conference highlighted recent advances in endocrinology, diabetes, and metabolism, with presentations focusing on diabetes, metabolic dysfunction, thyroid disorders, osteoporosis, and obesity.

In one study, John Gary Evans, M.D., of Saint Vincent's Medical Center in Jacksonville, Fla., and colleagues evaluated the change in diabetes-related medication expenditures before and after a 16-week lifestyle intervention program. The investigators also evaluated both clinical and metabolic changes as well as blood glucose control. Participants were individuals with type 2 diabetes who were obese or overweight. The Wellness Life Program included nutrition, fitness, and behavioral therapy.

"We were able to dramatically reduce the participants' doses of insulin and oral medications, on average, by 46 and 12 percent, respectively. Cost analysis, based on average wholesale price index, found that patients were able to reduce their 30-day prescription costs by nearly $143 per month," Evans said. "We also found an improvement in patient clinical and metabolic factors, with an average loss of 17 pounds over the study period, a reduction in body mass index of 3.0 kg/m², and a reduction in body fat index of 1.8 percent. We also found a reduction in hemoglobin A1c (HbA1c) of 0.7 percent. HbA1c was reduced by 1.3 percent for patients with a baseline HbA1c of 8 percent or more."

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In another study, Kathleen Figaro, M.D., of the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues used a national database, representative of the U.S. population, to evaluate the rates of complications associated with elective surgical procedures in patients with known diabetes, those with known diabetes and known diabetic complications, and those without diabetes.

"We found that the length of hospital stays and the costs associated with elective procedures were significantly higher in patients with diabetes and known diabetic complications. We found up to $4,000 in additional costs associated with elective procedures in patients with diabetes and known complications," Figaro said.

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Michael McClung, M.D., of the Oregon Osteoporosis Center in Portland, discussed the important advances that have been made in the field of osteoporosis and the failure to effectively translate these advances from clinical research studies to clinic practice.

"We now have very effective tools (bone mineral density testing and the Fracture Risk Assessment Tool) to identify older men and women with osteoporosis and at high risk for fracture. Older adults with a recent fragility fracture, especially of the spine, hip, shoulder, or wrist, are at high risk for having another osteoporosis-related fracture," McClung said. "We have several treatment options that substantially (50 to 70 percent) reduce the risk of osteoporosis-related fractures in patients at high fracture risk. These medicines are, in general, well tolerated and safe."

However, according to McClung, many patients with osteoporosis and most patients who have recently had a fracture are not being evaluated, and many of those with osteoporosis and/or at high fracture risk are not being treated. In addition, most patents who start treatment stop taking the medicine within one year.

"As a result, the advances made in our clinical research studies are not being used by many physicians and not being realized by patients who could benefit," McClung added. "Endocrinologists and the AACE can contribute to the resolution of these problems by collaborating with other societies and specialists to develop a clear, practical, believable message, based on the strong scientific evidence we have and good clinical judgment."

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Physician's Briefing