ACP Testimony to Senate HELP Committee on Stabilizing Individual Insurance Market

ACP Statement to House Ways and Means Committee Health Subcommittee Hearing on the Collapse of Private Practice: Examining the Challenges Facing Independent Medicine

ACP Statement to the Senate Finance Committee on COVID-19 Health Care Flexibilities

ACP Statement to the Senate HELP Committee Regarding Healthcare Costs

ACP Statement to the House Energy and Commerce Health Subcommittee on CMMI Hearing

ACP Statement to the Senate Finance Committee on Bolstering Chronic Care in Medicare

ACP Statement to the Senate Finance Committee on Bolstering Chronic Care in Medicare

ACP statement to the Senate Judiciary Subcommittee regarding the important role of immigrants in the U.S. health care system

Joint Issue Brief on Improving Access to Naloxone

Joint Coalition Statement in Support of Medicare"s Plan to Pay More for Office Visits and Other Essential Services

Yes We (S)can!

Ensuring Sustainability of Needed Antibiotics: Aiming for the DART Board

Types of Information Compromised in Breaches of Protected Health Information

Pregnancy in Women With Lupus: We Have Come So Far and Have So Far to Go

Answering the Clinical Research Challenge in a Growing Health System

Area Deprivation and Inequalities in Health and Health Care Outcomes

Duration of Antibiotic Therapy: Shorter Is Better

Dispense With Supplements for Improving Heart Outcomes

Sodium–Glucose Cotransporter-2 Inhibitors: Lack of a Complete History Delays Diagnosis

On 15 May 2015, the U.S. Food and Drug Administration (FDA) warned that administration of sodium–glucose cotransporter-2 (SGLT2) inhibitors could lead to ketoacidosis in patients with diabetes mellitus. This announcement came more than 2 years after the FDA's first approval of an SGLT2 inhibitor, although the phenomenon had been known for more than 125 years. Luminaries of diabetes research (including Josef von Mering, Frederick Allen, I. Arthur Mirsky, and George Cahill) had described ketosis and ketoacidosis induced by administration of the phytochemical phlorizin, the prototypical SGLT inhibitor, as well as in patients with familial renal glucosuria, a condition that is considered a natural model of SGLT2 inhibition. Neither government regulators nor manufacturers of SGLT2 inhibitors evinced an awareness of this extensive historical record. The absence of historical inquiry delayed notice of ketoacidosis as an adverse reaction, which could have reduced the burden of illness from these drugs.

Cases in Precision Medicine: Should You Participate in a Study Involving Genomic Sequencing of Your Patients?

Internists and other physicians may be asked to participate in research studies that include genomic screening of their patients. Because genomic studies can identify many variants with potential clinical or personal implications, physicians should carefully consider the effect of participation on their patients, as well as the time and effort needed for the physicians to interpret the results and decide how best to use the information. Among the questions they will need to explore is whether testing will be done in a laboratory that is certified under the Clinical Laboratory Improvement Amendments and authorized to generate results for clinical purposes. Physicians should also determine which results will be returned and how these results are likely to affect their patients. Consent must be obtained from patients for return of results, and physicians may want to use the various informational tools that are available to help their patients through the process of deciding which results to receive. Given the complexity of genomic results, including variable penetrance and possible preventive interventions, the research study should support physicians in understanding the results and their implications for patients. Physicians should be prepared to communicate results in a manner that facilitates patients' understanding of the findings and their implications, using a communication process tailored to the needs of the individual patient. Engaging genetic counselors in helping patients understand the implications of genomic findings can be helpful because of their scientific understanding of genetic disorders, experience in dealing with patients, and training in counseling skills.