Medical News

One Sweet Idea

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According to the CDC, the incidence of diabetes increased 90% during the 10-year period ending in 2007. So is any company working in the brokerage market surprised to hear that some competitors are now offering Preferred rates to applicants who have IGT?

“He doesn’t have diabetes. He has IGT, not diabetes.”

This is one slippery slope. I strongly caution underwriters to be extremely selective when offering the best mortality rate for future diabetics. Take a hard look at the applicant’s health behaviors trend. Whether or not an individual goes on to develop full-blown diabetes from an impaired glucose tolerance state is strongly dependent upon current and future behaviors.

Last century when I was President of the Texas HOLUA I had the opportunity to ask one of the leading diabetes specialists some questions about my personal situation. Dr. Norman Kaplan at Southwestern Medical Center, University of Texas, Dallas addressed the group and I talked family history with him. I mentioned my strong family history for diabetes and asked Dr. Kaplan how I could avoid diabetes in the future. His reply was simple and eloquent:

“Stay as thin as you possibly can.”

Good advice for a lot of what ails you.

The Lesser of Two Evils

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Back in May the FDA released an advisory on Chantix. The same month a study from The Institute for Safe Medication Practices shed light on the numbers:

  • 544 reports suggesting Chantix may be related to a loss of glycemic control
  • 224 reports classified as potential cardiac rhythm disturbances
  • From May 2006 through December 2007, the FDA received 227 reports of suicidal acts, thoughts or behaviors, 397 cases of possible psychosis and 525 reports of hostility or aggression.

I think I’d rather keep smoking.

Bye Bye Byetta?

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The FDA just updated their safety information on Byetta to reflect the reports of 6 cases of hemorrhagic necrotizing pancreatitis in people taking the drug. All six required hospitalization and two have died. If you know any diabetics taking this drug, please advise them of this information. Sooner, not later. I’ve added a link to the FDA MedWatch page on the sidebar under drug abuse.

Thinking About Heath..Just Another FME

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I’ve been thinking about Heath Ledger’s death and the release of the new Batman movie and the fact that it broke all box office records for a weekend opening at over $155 million.  I guess no one really cares about Ledger’s death anymore and that’s a shame.  The movie’s opening weekend was a perfect opportunity for the movie industry to make a statement about the dangers of prescription drug abuse.  Of course, I’m dreaming.  But one nagging thought kept recurring. How could anyone take a combination of oxycodone, hydrocodone, diazepam (Valium), temazepam (Restoril), alprazolam (Xanax), and doxylamine and think even for a moment that doing that was OK? Another recurring thought was that this thing has to be bigger than the death of one movie star. This thing has to be huge. Well, I found out today just how huge. I learned a new acronym today – FME or fatal medication event.

Multiple online sources quoted statistics from a research study published in the July 28 issue of the Archives of Internal Medicine. Now how’s this for a fun project? The researchers read almost 50 million death certificates from the United States between Jan. 1, 1983, and Dec. 31, 2004. Nearly 225,000 involved FME’s. The overall death rate from FME’s increased 360.5 percent during that time period.

But the increase in FMEs in people aged 40 to 59 was 890.8%.

Professional life underwriters should be scared. I know I am. I’ve added a link to the FDA website on medication errors. Check it out.

Read a Book a Week – On the Shelf

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I’ve just finished reading the best book on the prevention and management of Type 2 diabetes. The recommendations in Beating Diabetes are based on evidence from a randomized controlled clinical study called the Diabetes Prevention Program.. This book needs to be in your underwriting library and would make an excellent text for training purposes. But for those of you who may not have the time to find and read the entire book, I’ll summarize the key points:

  • Eat less
  • Move more

The book focuses on weight loss strategies and lifestyle modification. Get it, read it, live it.

Would You Like Some Statins With That Double Cheeseburger?

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I’ve been thinking about this for a few days, pondering what to write. It’s simple really.

This is just so wrong…

So would you rate an 8 year old on statins?

AAP ISSUES NEW GUIDELINES ON CHOLESTEROL SCREENING

Below is a policy on a clinical report appearing in the July issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP).

For Release: July 7, 2008, 12:01 am (ET)

The American Academy of Pediatrics has issued new cholesterol screening and treatment recommendations for children. The policy statement, “Lipid Screening and Cardiovascular Health in Childhood,” recommends cholesterol screening of children and adolescents with a family history of high cholesterol or heart disease. It also recommends screening patients whose family history is unknown or those who have other factors for heart disease including obesity, high blood pressure or diabetes. Screening should take place after age two, but no later than age 10. The best method for testing is a fasting lipid profile. If a child has values within the normal range, testing should be repeated in three to five years. For children who are more than eight years old and who have high LDL concentrations, cholesterol-reducing medications should be considered. Younger patients with elevated cholesterol readings should focus on weight reduction and increased activity while receiving nutritional counseling. The statement also recommends the use of reduced-fat dairy products, such as two percent milk, for children as young as one year of age for whom overweight or obesity is a concern.

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The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.

© COPYRIGHT AMERICAN ACADEMY OF PEDIATRICS, ALL RIGHTS RESERVED

Medical Information – Enough is Enough or Is It?

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My thoughts have crystalized on the amount of medical information you need to know to compently underwrite life mortality risk. Consider what follows to be totally unscientific and strong personal opinion based on experience. I developed this opinion from reading way too many APS’s in my lifetime and some recent observations from #1, the pre-Med student. After shadowing some doctors and observing a few colonoscopies, an EGD and knee arthroscopy up close and personal, #1 made this comment:

“Wow, specialists need to know a lot more than a family medicine doctor.”

Classic Duh, what do you think? But his comment got me thinking about what we do for fun and money. I have always thought I would make a good GP/Family Medicine type of doctor. Aside from the real world reasons why I didn’t pick that path, I understood intuitively why I have felt that way. I am the ultimate generalist. I like to do something intensely for a few years and then do something else. This drives my wife crazy. It’s not a real good strategy either for building up a nice pension. I also don’t recommend this strategy for career development. But hey, it’s what I am.

I’m drifting here. My thoughts have crystallized. We are underwriters. We don’t need nor will ever use the knowledge a specialist in medicine requires. All we need to be are halfway decent family medicine practitioners with an emphasis on preventative care. We need to understand what diseases and what behaviors will kill you. So how do you become a quasi-family practice person without the medical school training? I have to think about this some more. As always, comments and input are appreciated.

Too Much Information…Too Little Time

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It has always been hard to keep up with current medical advances and everything else you need to know to underwrite mortality risk. For several years I’ve used an online aggregator for all of the RSS feeds I find interesting and useful to create my own little news service. Only recently did I discover I could publish links in the form of a blog to share with others. In the blogroll sidebar I’ve included a link to my other blog under medical and health news for underwriters. This is a quick and efficient method for keeping up with what you should be keeping up with.