House passes $35-a-month insulin cap as Dems seek wider bill was reported by Ricardo Alonso-Zalvivar for, 31 March 2022.  

The House has passed a bill capping the monthly cost of insulin at $35 for insured patients, part of an election-year push by Democrats for price curbs on prescription drugs at a time of rising inflation.

Experts say the legislation, which passed 232-193 Thursday, would provide significant relief for privately insured patients with skimpier plans and for Medicare enrollees facing rising out-of-pocket costs for their insulin. Some could save hundreds of dollars annually, and all insured patients would get the benefit of predictable monthly costs for insulin. The bill would not help the uninsured.

But the Affordable Insulin Now Act will serve as a political vehicle to rally Democrats and force Republicans who oppose it into uncomfortable votes ahead of the midterms. For the legislation to pass Congress, 10 Republican senators would have to vote in favor. Democrats acknowledge they don’t have an answer for how that’s going to happen.

“If 10 Republicans stand between the American people being able to get access to affordable insulin, that’s a good question for 10 Republicans to answer,” said Rep. Dan Kildee, D-Mich., a cosponsor of the House bill. “Republicans get diabetes, too. Republicans die from diabetes.”

Public opinion polls have consistently shown support across party lines for congressional action to limit drug costs.  But Rep. Cathy McMorris Rodgers, R-Wash., complained the legislation is only “a small piece of a larger package around government price controls for prescription drugs.” Critics say the bill would raise premiums and fails to target pharmaceutical middlemen seen as contributing to high list prices for insulin.

Read more:  House passes $35-a-month insulin cap as Dems seek wider bill

Diabetes is ‘facet’ of long COVID syndrome was posted by Erin T. Welsh for, 1 April 2022.  

Individuals with COVID-19 had increased risk and burden for diabetes and use of diabetes drugs at least 30 days after infection compared with people without COVID-19, according to data published in The Lancet Diabetes & Endocrinology.

In addition, risk and burden increased with increasing severity of acute COVID-19, according to Yan Xie, MPH, a biostatistician from the Clinical Epidemiology Center at the Research and Development Service at the VA Saint Louis Health Care System in Missouri, and Ziyad Al-Aly, MD, assistant professor at the School of Medicine at Washington University in St. Louis, director of the Clinical Epidemiology Center, and the chief of research and education service at VA St. Louis Health Care System.

“Taken together, current evidence suggests that diabetes is a facet of the multifaceted long COVID syndrome and that post-acute care strategies of people with COVID-19 should include identification and management of diabetes,” Xie and Al-Aly wrote.

Read more:  Diabetes is ‘facet’ of long COVID syndrome

Burning Calories with Sleep was shared by Daniel Ganninger for, Issue 39, 27 March 2022.  

A 160-pound person will burn about 552 calories after 8 hours of sleep (69 cal/hr), while a 200-pound person will burn roughly 688 calories after sleeping 8 hours (86 cal/hr). A Big Mac is 563 calories, just for reference.

Energy used during sleep is calculated using a Metabolic Equivalent or MET value. The MET value is the energy cost of an activity. For sleep, that value is 0.9 MET.

Here’s how to calculate how many calories you’ll burn during sleep based on your weight: 0.9 MET x 3.5 x your body weight in kilograms (divide pounds by 2.2 to get kilograms) ÷ 200 = how many calories burned per minute. Take that amount and multiply it by how many minutes you slept, and you’ll get how many calories you’ve burned sleeping. Or you could take the easier route and use one of the many online calculators.

And more on sleep: Why You’re Taller in the Morning and Shorter At Night, also by Daniel Ganninger, on, 19 September 2021.  

A fascinating natural phenomenon occurs each night we go to sleep. We all get a little taller. And as the day goes on, we all get a little shorter. Even though what happens is complex, the explanation is relatively simple.

You probably don’t feel taller in the morning after waking from a good night’s sleep, but you’ve actually grown. The reason lies in the vertebral column, specifically in what is known as the nucleus pulposus, or the inner part of the vertebral disc. The discs in the spine are composed of a gelatin-like material that provides cushioning and protection to the spine. It’s your body’s shock absorber, and with the pounding your vertebrae take during the day with walking, running, bending, lifting, and sitting, it needs time to rest and rejuvenate.

During the night, when there is no load placed on your spine, fluid is slowly diffusing into the discs in a passive process called imbibition. Without forces compressing the spine, which includes gravity when you’re standing or sitting, discs grow in size due to osmotic pressures. An analogy to consider is that of a balloon with extremely tiny holes in it that is filled with gelatin and water sitting in a tub of water. When the balloon is compressed, water seeps out, decreasing the volume in the balloon. When the compression is released, the reverse happens. Each disc goes through this process at rest and increases in height by a small amount.


Amid doctor shortage, NPs and PAs seemed like a fix. Data’s in: Nope. was written by Andis Robeznieks for, 17 March 2022.

An examination of cost data for the South Mississippi system’s accountable care organization (ACO) revealed that care provided by nonphysician providers working on their own patient panels was more expensive than care delivered by doctors.

This prompted Hattiesburg Clinic leaders to redesign the clinic’s care model and to publish their findings. Hattiesburg Clinic employed a total of 26 physician assistants (PAs) and nurse practitioners (NPs) in 2005 and today there are 118. Along with certified registered nurse anesthetists and optometrists, they are part of a team of 186 nonphysician providers at the clinic, also called advanced practice providers (APPs).

“Over the past 15 years, in the face of physician shortages, especially in primary care, Hattiesburg Clinic made decisions to expand our care teams with the use of advanced practice providers,” says a study entitled “Targeting Value-based Care with Physician-led Care Teams” that was published in the Journal of the Mississippi State Medical Association.




“Focusing specifically on primary care, because our shortage of physicians there was so dire—due to retirements, massive panel sizes and lack of medical students entering primary care residencies—we allowed APPs to function with separate primary care panels, side by side with their collaborating physicians,” the study adds.

In hindsight and “with a wealth of internal data,” which includes cost data on more than 33,000 patients enrolled in Medicare, “the results are consistent and clear: By allowing APPs to function with independent panels under physician supervision, we failed to meet our goals in the primary care setting of providing patients with an equivalent value-based experience.”

Nephrologist John M. Fitzpatrick, MD, president of Hattiesburg Clinic and another co-author of the study, said “four of the five top highest-cost providers were nurse practitioners.” That finding “prompted us to really analyze the whole population and, ultimately, led to the findings in the paper. This was surprising, as these are typically considered ‘process’ measures that can be adequately handled by nonphysician staff,” the study says.

    • In fact, patients who saw a non-doctor as their primary care provider (PCP) had higher rates of ED (Emergency Dept) use than patients without a PCP.
    • The data also showed that physicians performed better on nine of 10 quality measures, with double-digit differences in flu and pneumococcal vaccination rates.
    • Physicians also had higher average patient-satisfaction scores across six domains measured by Press Ganey.

Read more:  Amid doctor shortage, NPs and PAs seemed like a fix. Data’s in: Nope.

Stress … and How Stress Levels Affect our Blood Sugar was posted by Dr. David Ahn on his latest Dr. Ahn’s Weekly Diabetes Videos, 30 May 2022. 

Dr. Ahn is an endocrinologist/bariatrician, Program Director at the Mary and Dick Allen Diabetes Center, Hoag Hospital, Newport Beach, CA, Dr. Ahn is also my endo! 

You can subscribe and ask a question for a future event: Dr. Ahn’s Weekly Diabetes Videos

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