Continuous Glucose Monitoring: An Opportunity for Population-Based Diabetes Management.

The increasing prevalence of prediabetes and diabetes in the United States poses a serious threat to the health of the population. Closely associated with obesity, hypertension, dyslipidemia, and cardiovascular disease, a diagnosis of diabetes or prediabetes carries with it life-altering demands. Critically important among these is the requirement for frequent glucose level checks-typically performed with blood obtained from a fingerstick. Innovative real-time continuous glucose monitoring (rtCGM) technology makes it possible for patients and their clinicians to receive continuous glucose level measurements around the clock without finger sticks. Accruing evidence shows that rtCGM is an effective tool for patients and their clinicians in managing diabetes (ie, maintaining glucose levels within the recommended target range) and in understanding how lifestyle behaviors directly influence glucose levels. In recent years, a number of large payer organizations (eg, private health insurers, employers) have incorporated rtCGM in their diabetes management programs as a means of addressing the dual challenge of achieving/maintaining control of glucose levels and preventing or delaying the onset of complications. Programmatic integrated approaches have been used successfully and cost-effectively for managing other chronic conditions. Incorporating rtCGM in similar integrated approaches in diabetes management may be of value in improving quality outcomes and reducing costs on a population level. The evidence supports broader adoption and continued study to evaluate models that incorporate the use of rtCGM.

Spicy food and self-reported fractures.

BACKGROUND & AIMS: Population-based evidence that suggests health effects of spicy consumptions on fracture was scant. The study aimed to explore the association of spicy food intake with self-reported history of fractures in the Chinese populations. METHODS: Data was drawn from the baseline survey of a large cohort study conducted in China between 2004 and 2008. A total of 512,891 adults (including 302,632 females) were included. Frequency, strength and duration of spicy food consumption were assessed using a survey questionnaire. Fracture history was self-reported based on physician's diagnoses. Multivariate logistic regression models stratified by socio-economic factors, body mass index and other lifestyle factors were performed adjusting for potential confounders. RESULTS: The prevalence of daily spicy food intake was 30.32% in males and 29.90% in females. The adjusted odds ratios for fractures were 1.04 (95% CI: 1.01-1.07) for those who ate spicy food occasionally, 1.10 (95% CI: 1.05-1.16) for those who ate one or two days a week, 1.15 (95% CI: 1.09-1.20) for three to five days a week, and 1.12 (95% CI: 1.07-1.17) for daily consumers, compared to participants who never ate spicy food. Participants who ate weak spicy food (OR: 1.10, 95% CI: 1.14-1.23), moderate spicy food (OR: 1.11, 95% CI: 1.06-1.15) and strong spicy food (OR: 1.18, 95% CI: 1.12-1.25) were more strongly associated with self-reported history of fracture. In addition, the strengths of associations were consistently stronger with the duration of spicy food exposure. In stratified analyses, the strength of such an association appeared stronger in rural areas (OR: 1.14, 95% CI: 1.09-1.20) than urban (OR: 1.09, 95% CI: 1.05-1.12). The correlation was consistently stronger in males than in females. CONCLUSIONS: Among Chinese adults, a positive cross-sectional association between the level of spicy food intake and history of fractures was found in both sexes.