In this trial of 2368 diabetics with CAD, they randomized (in a 2X2 factorial fashion) to either revascularization (within 4 weeks) or medical treatment, and to either insulin provision therapy (insulin or sulfonylurea) or insulin sensitization therapy (metformin or thiazolidinedione). There were no significant differences between the groups in 5-year death / major cardiovascular events. However, those undergoing CABG (and not PCI) had lower CV events than those undergoing medical treatment (abstract). An editorialist summarizes the findings:For diabetics with CAD, initial medical therapy is reasonable, but if revascularization is warranted, CABG is the preferred choice for diabetics.
What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… […]
As a nurse practitioner in hospital medicine I have multiple opportunities to interact with all sorts of physician hospitalist colleagues, hospital medicine group leaders, quality officers etc. Often their interactions with me take on a certain wary curiosity, like I am some exotic monkey or another creature that is unfamiliar to them. If I am […]
By reading the headlines recently, practitioners would not know if they saved or tanked the healthcare system. One day disaster looms, the next we have moderated growth and business can continue as usual (and by business, I mean doing the correct things correctly). A new study, along with some recent data, helps shed some light […]