Insight News

Feb 12th

Health Briefs: Are Doctors Missing Diabetics?

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MADISON, Wis. -- If you are 45 years and older, overweight and have high-risk factors such as high blood pressure and cholesterol, you should ask your doctor for a diabetes test during routine visits, says Dr. Ann Sheehy, a hospitalist at University of Wisconsin Hospital and Clinics.

“Since Type 2 diabetes is often asymptomatic, most people are not aware they have the disease until they have a blood test showing elevated blood glucose,” she said.  

Doctors may also miss the diagnosis because one of the two main national screening guidelines they use doesn’t identify about one-third of those with diabetes.

That’s what Sheehan and collaborators found in a study comparing the two guidelines—one from the American Diabetes Association (ADA), the other from the U. S. Preventive Services Task Force (USPSTF).

According to the study, the USPSTF guideline, which recommends diabetes screening only for people with high blood pressure, missed the mark substantially. The ADA test was much more reliable.

Better Tests for Prostate Cancer

MADISON, Wis. -- A test in the pipeline could help avoid the confusion surrounding prostate screening. The standard screening test today, the PSA test, may expose too many men to needless procedures that have potential side effects.

“We need better tests to allow us to predict the biology of these cancers so we can do a better job of identifying who needs treatment and who doesn’t," says Dr. David Jarrard, a professor of urology at UW School of Medicine and Public Health.

The new test measures levels of ionized calcium in the blood. Researchers at the UW School of Medicine and Public Health have found that men who had the highest levels of ionized calcium were three times more likely to die later of prostate cancer.

The test, currently in development, could give a better indication of when to treat the cancer, or when to wait and watch. Such a test could be most useful when deciding whether to do a biopsy of a suspected prostate tumor, says Jarrard.

Driving on Shaky Footing?

MADISON, Wis. – Broken a bone due to icy sidewalks? Your next question probably is whether it’s safe to drive while wearing a cast.

A University of Wisconsin foot-and-ankle specialist who recently completed a preliminary study of the question says the answer is clearly no.

Dr. Kurt Rongstad, assistant professor of orthopedic surgery at UW School of Medicine and Public Health, did a simulated-driving research study on driving with a cast. Rongstad now tells his patients that orthopedic boots or “cam walkers” slow braking time enough that driving while wearing them is unsafe.

“Usually I like to base my opinions on evidence-based medicine, but there weren’t any studies on the topic,’’ he said. So he decided to create one.

The timed-reaction study required the 42 subjects to lift their right foot off the gas pedal, move to the brake, and depress the brake pedal after a light flashed. It took about 25 percent longer for them while wearing casts than while wearing regular shoes. “Clearly and statistically, we found that braking time was inferior with the high or short-leg cam walker," he said.

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