February 1, 1998, Tip Sheet
Annals of Internal Medicine is published by the American College of Physicians (ACP), an organization of more than 100,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For a copy of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. The full text of selected articles can be accessed on the Internet at http://www.acponline.org/journals/annals on Feb. 1, 1998.
Study Recommends Treating Type 2 Diabetes First with Oral Medications, Then Insulin
A new prospective study of patients with newly diagnosed type 2 diabetes that could not be controlled with diet found that initial insulin therapy resulted in more hypoglycemic reactions and weight gain without better control of blood sugar levels than initial therapy with oral medications. (Article, p. 165.)
Heart Surgery Often Leads to Kidney Problems; Profiles Help Identify High-Risk Patients
Myocardial revascularization often leads to kidney problems or kidney failure, resulting in longer hospital stays and higher death rates, a prospective study finds. (Articles, p. 194.) The study findings help identify high-risk patients, which, in turn, can help patients and physicians make informed decisions about surgery and point the way to reducing the risk for these serious and expensive complications.
Review Shows When to Use Which Treatment for Coronary Artery Disease
A review of data on the treatment of chronic, stable angina found initial medical therapy a reasonable choice for low-risk patients; angioplasty or bypass surgery for moderate-risk patients, depending on the heart's condition and patient preference; and bypass surgery for high-risk patients. (Review. p. 216.)
Firearm Injury Should Be a Major Public Health Issue for Physicians
-- ACP Asks Physicians to Help Stem Firearm Violence
-- New Survey Finds Internists and Surgeons Support Patient Counseling and Community and Legislative Efforts to Curb Firearm Injuries
-- Editorial Says 'Medicalization' of Issue Is Necessary
(Medicine and Public Issues, p. 224; Position Paper, p. 236; Editorial, p. 234.)
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