The Pedometer Project: Steps that Make a Difference

With the end of 2006 a few days away many of us turn our thoughts to the New Year and seize the opportunity to rededicate ourselves to healthier habits. I personally know all too well how easy it is to stop exercising and how hard it is to start again. I also know how insidious inactivity can be. In the last month alone, I've had to tell three of my patients that they were in the earliest stages of developing diabetes. For them, the need to exercise and to pay compulsive attention to their diet ...
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Reclaiming the Q Word

A generation ago, in the bad old days, physicians were thought of as unquestioned experts who dispensed orders rather than advice, and expected dutiful compliance from their patients.  Fortunately those days are long gone, and today the patient and the physician see each other as partners in the patient's healthcare, with the patient able to question and even challenge the doctor's recommendations.  This keeps doctors smart and honest and keeps patients ultimately in control of their health.  Bu...
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Medication Options in Newly Diagnosed Type 2 Diabetes

Over a dozen years ago, when I was a medical student, treatment of type 2 diabetes was very simple. There was only one family of oral diabetes medicine -- sulfonylureas. In patients for whom the sulfonylureas failed, the only option was insulin injections. Sulfonylureas suffer from two serious side effects. They cause weight gain, an especially frustrating problem since weight loss is so important in diabetes. They can also cause blood sugar levels to become too low (hypoglycemia) which can have...
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Management of Menopausal Symptoms

Yesterday's issue of the New England Journal of Medicine had a very helpful review article: Management of Menopausal Symptoms. (The full text is available even to non-subscribers.) The article reviews the existing evidence about the prevalence of symptoms related to menopause and the risks and benefits of various treatments. I summarize the article below. The symptoms most associated with menopause are v...
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