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18 September 2007 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information. For an embargoed copy of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656.

Both Aerobic and Resistance Exercise Improved Blood Sugar Control in People with Diabetes. Combination of the Two Exercises Did Even Better

In a new randomized controlled trial, both aerobic and resistance exercise improved glycemic/blood sugar control in people with type 2 diabetes. The greatest improvements came from combined aerobic and resistance training. The study included 251 adults, between ages 39 and 70, who were not exercising regularly and had type 2 diabetes. Participants were assigned to one of four groups: performing 45 minutes aerobic training three times per week, 45 minutes of resistance training three times per week, 45 minutes each of both three times per week, or no exercise.

ACP: Set Blood Sugar Targets for People with Diabetes

The American College of Physicians, in a new guidance statement, advises physicians to set targets for the A1c values of patients with type 2 diabetes (Clinical Guidelines, p. 417). ACP recommends that A1c target level should be based on individualized assessment of risk of complications from diabetes, comorbidity, life expectancy, and patient preferences. A hemoglobin A1c level of less than 7 percent is a reasonable goal for many but not all patients to prevent microvascular complications. The A1c value is a number that reflects the average blood sugar level over the past three months.

Drugs Dangerous to Fetuses Often Prescribed to Women of Childbearing Age

A study of prescription class D or class X drugs (which the FDA says can potentially damage embryos and fetuses) found that many women of childbearing age were given prescriptions without documentation of concurrent birth control services (Article, p. 370). Researchers studied HMO records of nearly 500,000 women aged 15 to 44 who filled prescriptions in 2001 and compared the rates of documented birth control services and pregnancy in women prescribed Class D or X drugs with those prescribed drugs known to be safer in pregnancy (Class A or B drugs).

Although the researchers did not have data available to them to be certain that all of the women prescribed potentially unsafe drugs were at risk for becoming pregnant (some may not have been sexually active) and some physicians may have provided verbal counseling not reflected in the database, this study suggests that a substantial proportion of women who receive drugs that are potentially unsafe during pregnancy may not be receiving appropriate birth control services or advice.

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