Publications by authors named "P D Reaven"
Objective: To determine the health care cost savings from the Wellth app, a mobile health intervention that uses financial incentives to increase medication adherence.
Study Design: An observational study of members in one of Arizona's Medicaid managed care plans, part of Arizona Health Care Cost Containment System (AHCCCS), using the Wellth app from March 28, 2020, to January 12, 2021. One-to-one matching was used to identify comparable nonparticipants, and a difference-in-differences approach was used to estimate the impact of the Wellth intervention on outcomes defined over the 9 months before and after using Wellth.
Objective: Higher truncated-to-native apolipoprotein (apo) C-I proteoform ratios (C-I'/C-I) are associated with favorable cardiometabolic risk profiles, but their relationship with longitudinal changes in insulin resistance (IR) and incident diabetes is unknown.
Research Design And Methods: Plasma apoC-I proteoforms were measured by mass spectrometry immunoassay at baseline in 4,742 nondiabetic participants in the Multi-Ethnic Study of Atherosclerosis (MESA) and 524 participants with prediabetes in the Actos Now for Prevention of Diabetes (ACT NOW) study. The primary outcome was incident diabetes (fasting glucose [FG] ≥7.
Article Synopsis
- Continuous glucose monitoring (CGM) can enhance diabetes management for patients on insulin, but our study found disparities in CGM prescriptions among different racial and ethnic groups among U.S. Veterans.
- Out of 368,794 patients, only 11.2% received a CGM prescription, with notably lower rates for Black or African American (9.2%) and Hispanic or Latino patients (8.3%) compared to White patients (11.8%).
- After adjusting for various factors, Black or African American patients had 38% lower odds and Hispanic patients had 21% lower odds of being prescribed CGM than their non-Hispanic White counterparts, highlighting ongoing racial disparities in healthcare access.
Article Synopsis
- The study aimed to create and validate algorithms that can effectively identify cases of diabetic retinopathy (DR) from electronic health records (EHRs) across three different healthcare systems.
- The algorithms were assessed based on specific criteria for identifying DR cases and diabetes controls, yielding high positive and negative predictive values (PPV and NPV) across the different systems tested.
- Results showed that while the algorithms performed well overall, there were some variances in their effectiveness, especially when comparing different healthcare systems, highlighting the need for further validation to enhance their reliability.
Article Synopsis
- Diabetes complications, like retinopathy and neuropathy, occur more frequently in individuals of African ancestry, partly due to G6PD deficiency which is associated with malaria resistance and lowers HbA1c levels by affecting red blood cell lifespan.
- A study discovered a specific variant (rs1050828-T) linked to G6PD deficiency that increases the risk of diabetes complications, showing that glucose levels influence retinopathy risk significantly.
- The findings suggest that adjusting diabetes management based on glucose levels or genetic factors could improve diagnosis and treatment, potentially reducing complications for those with G6PD deficiency.