According to a study published in the December issue of American Journal of Physiology – Heart and Circulatory Physiology, widely used diabetes drugs affects men’s and women’s hearts differently. The researchers studied the effect of three commonly prescribed medications metformin, rosiglitazone (sold under the brand name Avandia) and Lovaza (omega-3 fish oil medication) on 78 type 2 diabetes affected patients comprised 43 women and 35 men. They were divided into three groups – one group was given metformin alone, the next group was given metformin, plus rosiglitazone, and the last group was given metformin plus Lovaza. The researchers found even though the drugs controlled blood sugar levels in both genders equally well, but had different and sometimes opposite effects on the male and female heart.
The major findings of this study are as follows:
- Metaformin lowers fat metabolism in women and increases glucose uptake by their hearts and thereby brings about positive effects on women’s hearts. The heart metabolism will further improve in women while taking rosiglitazone with metformin rather than taking metformin alone.
- In men, metaformin causes the heart metabolism to burn less sugar and more fat. As per the researchers, chronic burn of fat by the heart can cause harmful changes that may result in heart failure. In the opinion of senior author of the study, Dr. Robert Gropler, metformine alone can worsen heart metabolism in men instead of making it more normal. The study found either taking rosiglitazone or lovaza in addition to metformine can reduce the negative effects of metaformin alone in men.
- The addition of lovaza to metformin can’t cause a strong effect on both men and women.
Though the study did not prove a cause-and-effect for drug combinations and heart changes, it stressed the need to define diabetes therapies optimal for men and women. However, the findings of this study give us a hint about the risk of medication errors. We saw in the study that metaformine alone can have positive effects in women but negative effects in men. Family practice physicians need to be aware of the effects that a particular drug can have on a patient. Diabetes requires focused ongoing medical management and use of monitoring tests.
It is expected that electronic health records (EHRs) will help physicians improve the coordination and quality of care. However, a report published by the American Medical Association (AMA) in October 2013, says that while physicians note the benefits of EHR, some complained that the systems are burdensome to operate and are an important contributor to their dissatisfaction. The study found that EHR technology interferes with patient interactions, requires physicians to spend too much time on data entry, and detracts from the accuracy of medical records with template-generated notes.
Physician frustration and workload can be reduced in many ways. In addition to medical scribes to help with the tasks involved in data entry in electronic records, primary care physicians can rely on family practice medical transcription services for comprehensive clinical documentation. Support services such as these can go a long way in improving primary care physicians’ management of diabetes and other conditions.