The Cost of Chronic Disease

December 20, 2017

The primary issue that consumes the majority of the burden of healthcare costs in the United States is preventable chronic disease: while the most prevalent health conditions are simultaneously the most avoidable, they continue to cost the country’s budget billions of dollars. While overall numbers have decreased since 2010, when chronic disease cost the U.S. a total of $315 billion, morbid obesity rates have continued to rapidly spike—a condition that leads to a range of critical health issues including heart disease, diabetes, and stroke.

Primary care providers have long faced the struggle of determining how to implement best practice care for patients diagnosed with chronic diseases. Recent studies indicate that almost half of the entire U.S. population has at least one chronic health condition—including heart disease, cancer, diabetes, obesity, or arthritis. Statistics designate these health care treatments costs to account for 86% of cumulative national healthcare spending, and the CDC reports that chronic conditions are the leading causes of death and disability in the country.

Yet the past decade has seen the advent and proliferation of digital health technology, spurring the generation of new techniques and strategies for healthcare professionals to utilize in chronic disease management. These types of technology vary in terms of accessibility and usability, but include remote monitoring, mobile health apps installable on phones, and wireless wearables—which serve as activity trackers.

A series of interviews conducted by Medical News Today demonstrate a bright future for the potential of new technology, and its ability to spur and provide high-quality care. Suzanne Falck, MD, an associate professor of internal medicine at the University of Illinois College of Medicine, noted that a highly successful digital tool is currently in use for the management of heart failure: an implanted sensor immediately transmits data to a healthcare practitioner, who then analyzes the data in order to make medical recommendations. Further clinical trials and studies indicate that remote monitoring is more cost-effective than traditional, conventional management.

Moreover, the burgeoning popularity of medical apps signifies that mobile technology can make a hugely positive impact on chronic disease management. There are currently approximately 259,000 medical health apps available to purchase; over half are aimed at targeting consumers with chronic conditions. Clinical trials have repeatedly shown that patients with type 2 diabetes who utilized an app to monitor their blood glucose levels showed greater benefits than those who did not. A recent article in Diabetes Technology & Therapeutics states that the prognosis in patients with diabetes is ‘strongly influenced by the degree of control of their disease,’ which reinforces the effectiveness of self-management support through mobile apps.

Another innovative and exciting development is wearable technology and devices, which are currently being studied in a variety of clinical research settings. Many healthcare providers believe that the ‘potential of this technology is endless,’ as they can improve access to care while simultaneously enhancing convenience—and likely patient compliance.

Most importantly, being conscious of medicinal needs and treatments requires a consistently high level of responsibility and awareness. Healthcare experts urge patients to take active, informed roles in managing their health: online workshops have been developed to offer chronic disease self-management programs, which have been proven to significantly improve health statuses. Moreover, healthcare practitioners and professionals must collectively work together and utilize the new landscape of digital medical technology to their patients’ benefits.

Hard on the Heart: Disease of Depression

December 7, 2017

While medical experts have long known of the correlation between psychological and physical health, mental illness was not considered a major risk factor for cardiovascular disease—until a recent series of research confirmed that depression may serve as one of the most significant causes of heart problems.

Approximately 350 million people suffer from depression globally, according to data from the World Health Organization. According to new research, the risk of fatal heart disease in men due to depression is almost the same as the risk from elevated cholesterol levels, obesity, and smoking.  The findings further pointed to a greater need for heart health screenings among patients with depression, in addition to mental health checks for patients with cardiovascular disease.

The causality is twofold, as patients with pre-existing heart disease conditions are more likely to become depressed due to their poor health and otherwise healthy people diagnosed with depression are likewise significantly more apt to develop heart disease, compared to the general population. Viewed across the population, depression accounts for roughly 15% of cardiovascular deaths—comparable to the other known risk factors.

A professor of medicine at Harvard Medical School, Ahmed Tawakol, has conducted extensive research surrounding the connection between stress and heart health, stating that only over the past few decades “has mounting evidence suggested that stress and depression may be more than simple markers of heart disease; they might be important causes.”

While it remains unclear exactly how depression impacts heart health, it is likely that stress hormones play a critical role. Yet leading a healthy lifestyle—including diet, physical activity, managing stress, being smoke-free—is known to be effective in preventing and treating both depression and heart conditions.

Biomarkers Could Predict Best Diets

A new study, published in the American Journal of Clinical Nutrition, has indicated two biomarkers that can predict the efficacy of certain diets for weight loss: specifically, for people with prediabetes or diabetes.

Through an analysis of over 1,200 adults, researchers discovered that a person’s fasting blood glucose levels, fasting insulin levels, or both, could pinpoint which diets would most likely lead to weight loss. These biomarkers were particularly effective in determining which diets were best for people with pre-diabetes and diabetes.

Each year, millions of us attempt to lose weight through diets, but not all of us succeed. A new study has uncovered two biomarkers that could predict how effective certain diets will be for weight loss, particularly for people with prediabetes or diabetes.

Statistics from the American Diabetes Association indicate that approximately 29.1 million people in the Untied States have diabetes; estimates show that around 75 million people have pre-diabetes, yet almost 90% remain unaware. Type 2 diabetes is the most common form of the condition: the body is unable to effectively use the hormone insulin, which causes high blood glucose levels. For people with prediabetes, blood glucose levels remain higher than normal—yet not high enough to lead to a diagnosis of diabetes.

The researchers in the study believe that a person’s fasting blood glucose and insulin levels could be utilized to help identify the most effective diet for weight loss, after analyzing the data of three dietary clinical trials: the Diet, Obesity, and Genes trial, the OPUS Supermarket intervention (SHOPUS), and the Nutrient-gene interactions in human obesity (NUGENOB) trial. The subjects were all overweight; the researchers evaluated and assessed their fasting blood glucose levels, and fasting insulin levels, in order to determine whether the levels were associated with weight loss in response to certain diets.

These results symbolize a kind of breakthrough in personalized nutrition: among adults with prediabetes, the team found that a diet rich in whole grains, vegetables, and fruits was the most effective for weight loss. For example, in the SHOPUS trial, adults with prediabetes who followed a diet high in the aforementioned foods lost more weight than those who followed a controlled diet. For people with type 2 diabetes, the researchers found that a diet rich in plant-based, “healthy” fats, and low in carbohydrates, was most effective for weight loss.

The team reported that adding participants’ fasting insulin levels to the analysis further strengthened the identified correlations between diet and weight loss, confirming the hypothesis that fasting blood glucose and fasting insulin levels may be biomarkers for weight loss.