Statins in Diabetics

As discussed at lectures today, the American Diabetes Association 2012 Standards of Medical Care in Diabetes state:
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• Statin therapy should be added to lifestyle therapy, regardless of baseline lipid levels, for diabetic patients:
  
  • ○ with overt CVD. (A)
  • ○ without CVD who are over the age of 40 years and who have one or more other CVD risk factors. (A)
• For patients at lower risk than those above (e.g., those without overt CVD and under the age of 40 years), statin therapy should be considered in addition to lifestyle therapy if LDL cholesterol remains >100 mg/dL or in those with multiple CVD risk factors. (E)
• In individuals without overt CVD, the primary goal is an LDL cholesterol <100 mg/dL (2.6 mmol/L). (A)
• In individuals with overt CVD, a lower LDL cholesterol goal of <70 mg/dL (1.8 mmol/L), using a high dose of a statin, is an option. (B) 
  
  
  For full details, see the entire set of Standards at:
  http://care.diabetesjournals.org/content/35/Supplement_1/S11.full (Click on "Full Text" and search for Dyslipidemia)

Teaching Skills

The most commonly used method of case-based teaching is the:

One Minute Preceptor
Five Microskills for clinically based teaching*

1) Get a commitment

2) Probe for supporting evidence

3) Teach general rules

4) Reinforce what was done right

5) Correct mistakes

There are numerous examples available in the website link at the right under "videos" or "precepting". One of the best is from the "The Practical Prof" at The Alberta Rural Physician Action Plan.

* Neher JO, Gordon KCM, Meyer B, Stevens N. A five-step microskills model of clinical teaching. J Am Boar Fam Prac. 1992; 5:419-24

WHO Fracture Risk Assessment Tool

The World Health Organization Fracture Risk Assessment tool for the US is available at:
http://www.shef.ac.uk/FRAX/tool.jsp?locationValue=9

Make sure it is set to the correct country. You can also use the "Calculation Tool" menu to select specific ethnic groups.

CDC National MRSA Education Initiative

The Centers for Disease Control and Prevention (CDC) has a MRSA Education Initiative at:
http://www.cdc.gov/MRSA/

It includes specific information for Healthcare Providers, and a wealth of educational materials for pateints. The Patient education materials can be found at:
http://www.cdc.gov/mrsa/mrsa_initiative/skin_infection/?s_cid=dhqp_013#

As with all CDC materials, these are copyright free and available for reproduction and distribution.

Dr. Z.

Diabetes Resources for AAFP Scientific Assembly 2011

A few of my favorite resources for Diabetes Information
National Diabetes Education Program
Publications:
Numbers At-a-Glance

American Diabetes Association: www.diabetes.org
ADA Clinical Practice Recommendations

Diabetes Education Online (from the Diabetes Teaching Center at the University of California, San Francisco.

National Diabetes Prevention Program:
at the CDC.
at "the Y" (YMCA).

ABFM Board Exam iPhone App

For those looking to review Board questions on the go, the American Board of Family Medicine has released a free iPhone/iPod Touch app. The app reportedly includes 200 questions for your review. I found it by searching the App Store for "ABFM". You can check it out at:
The ABFM iPhone App link:

Board Exam Tips

As I noted at my last Board Review session, you can find some great tips for taking Board type exams at:
http://www.swansonfamilymedicinereview.com/tips.php

Please do not necessarily take this as an endorsement of their book.

Dr. Z.

P.S.: My personal favorite is Rule #6!