News in Brief: Week of Jan. 30-Feb. 3

This roundup includes the following news briefs:

According to a recent study report (abstract) published in the Annals of Internal Medicine, not all clinical practice guidelines on the use of oral medications for type 2 diabetes are consistent with the findings of a systematic review of the available scientific evidence that was funded by the Agency for Healthcare Research and Quality (AHRQ).

The study looked at 11 different guidelines on oral medications for type 2 diabetes to see how they matched up with seven evidenced-based conclusions from a 2007 AHRQ systematic review on the topic. (That evidence review has since been updated [650-page PDF; About PDFs].)

The report's authors found, for example, that seven of the 11 guidelines agreed that metformin is the favored "first-line agent," while 10 associated "higher rates of edema and congestive heart failure" with thiazolidinediones -- both conclusions reached in the AHRQ review. In addition, the study found that "guideline quality was generally low, and few guidelines graded the strength of their recommendations." None of the guidelines screened, however, flatly contradicted available evidence.

The NIH has released a fact sheet (12-page PDF; About PDFs) for patients undergoing A1C testing. The sheet includes information about the purpose of the A1C test, how it works, its accuracy and how it relates to other tests for diabetes.

Specifically, the A1C test is used to diagnose type 2 diabetes and prediabetes, as well as to monitor blood glucose levels of people with type 1 or type 2 diabetes.

The fact sheet is intended to help physicians explain the A1C test to patients and provides patients with a credible information resource after they leave the doctor's office. It also may be placed in exam rooms or reception areas for reference.

The cost of repealing the sustainable growth rate (SGR) formula just got more expensive, according to the Congressional Budget Office (CBO).

In its Budget and Economic Outlook report (165-page PDF; About PDFs) issued on Jan. 30, the CBO now says the 10-year cost of repealing the SGR stands at $316 billion, $26 billion more than when the CBO last calculated the rate (1-page PDF) in November. The SGR has called for steep Medicare payment reductions for the past several years -- reductions that have been averted only by last-minute congressional action. The postponements increase the cost of repealing the SGR.

Most recently, Congress passed a measure postponing for two months a 27.4 percent SGR-mandated payment reduction that was scheduled to take effect on Jan. 1. Without congressional intervention, physicians will again face that cut on March 1.

On Jan. 23, the American Heart Association published a scientific statement titled "Evaluating Parents and Adult Caregivers as 'Agents of Change' for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps" (23-page PDF; About PDFs).

The statement's authors evaluated the strength of evidence that suggests parenting strategies can change negative behavior associated with children with obesity. The researchers also reviewed strategies used by parents and adult caregivers in family-based treatment programs and evaluated whether or not greater parental involvement in treatment was associated with weight reduction in children with obesity.

In addition, the authors identified gaps in knowledge on the topic and called for additional study to advance the scope and potency of parent and adult caregiver participation in treatment for childhood obesity.