From the office of Robert S. Grimshaw Jr MD FACP Internal Medicine 3535 Hill Blvd Yorktown Hts NY 914 962-3180 NEWS Recognized Provider  “With Distinction” by the American Diabetes Association/National Committee for Quality Assurance 2/99-2/02

94                          January-February  2001

Fen-Phen Revisited

Heart Valves May Stabilize

From the Annals of Internal Medicine come 2 reports about the diet drugs fenfluramine, dexfenfluramine (Redux) and phen-termine. Groups from Washington (D.C.) Hospital Center and Duke University report that many patients show improvement at 1 year. Leakage of the aortic valve in particular was less in about 44% and half showed no worsening. Progression of mitral or aortic valve leakage occurred in only 5%. Most of the patients with significant heart valve trouble were on one or both drugs for at least 6 months; the most problems were seen in those treated for 2 years. These drugs were removed in 1997.

Another Winner: Florence Williams is our latest recipient of 2 movie tickets in our monthly draw-ing. You, too can be a winner if you get your colon cancer slide tests in on time! And you’re a winner by helping to prevent this major cancer.

Note for Our Medicare Patients: Some of you may have gotten a notice saying that these cancer screening tests are not covered; this was a computer glitch that Medicare has now corrected.

Please DO Send The Cards In! If they’re not back in 4 weeks, there’s a $10 charge due to our costs.

GlucoWatch is Coming: The FDA has approved the ‘through the skin’ glucose monitor, the GlucoWatch Biographer. This meter works by using a 12 hour sensor pad beneath it. Sugars can be checked every 20 minutes after a 3 hour warm-up period. A single blood test with a Glucometer, Accuchek, One-Touch or Precision meter is required. The company hopes to have the wrist meter available in the next few months. The costs are estimated at $300 for the watch and $4 each for the sensors. An estimated 16 million Americans have diabetes.

And a New Diabetes Drug has been released: nateglinide (Starlix). It is in the same class as repaglinide (Prandin), stimulating insulin release from the pancreas. It is taken 3 times a day before meals. The drug, which will often be used with other meds, costs about $100 per month.

Resistin: A Reason for Insulin Resistance? Researchers at the University of Pennsylvania may have solved part of the puzzle of what causes type 2 diabetes. Dr. CM Steppan and col-leagues isolated resistin from mouse fat cells (Resistin levels are higher in diabetics than normal people). One obvious therapeutic strategy is already being tried: antibodies to resistin lowered sugar levels in mice.

Arthritis Pain: From Bone Marrow? Most physicians and patients think that pain from osteo-arthritis comes from the cartilage in the joint. Not so, say researchers at Boston University. Writing in The Annals of Internal Medicine, Dr. David Felson and colleagues found that 77% of patients with painful knees had swelling (edema) of the marrow under the joint on MRI; only 30% of those with no pain did. The finding may well lead to new therapies.

Prescription Plan Faxes: Some of our patients have prescription plan coverage. If you do, please check if your plan allows us to fax your prescriptions to them. Then please fill out one of their forms with your name & other plan information leaving the drug info field BLANK and send it to us for your chart. We will use it as a master, adding the appropriate drugs each time you tell us you need a refill.

Remember to also send the plan’s fax telephone number. When you call the prescription line for refills, just mention you have a fax master in your chart. This will help us help you!