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AHCPR-Funded Studies Appearing in Today's JAMA Address

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Insulin Therapy for Type 2 Diabetes; Diagnostic Protocols for Chest Pain

Media Advisory Date: November 25, 1997

Two AHCPR-funded research projects appear in the November 26 issue of the Journal of the American Medical Association (JAMA). The first study finds that although insulin therapy can help type 2 diabetes patients initially bring their poor blood sugar levels into moderate control, it rarely helps moderately controlled type 2 diabetics achieve near-normal blood sugar levels—despite the increased expense of additional office visits, and home glucose monitoring. More effective interventions than conventional insulin therapy will be required for most patients to achieve a near-normal blood sugar level. This large patient outcomes study, entitled "Starting Insulin Therapy in type 2 Diabetes: Effectiveness, Complications and Resource Utilization," is authored by Dr. Rodney A. Hayward, M.D., professor of medicine at the University of Michigan and Sheldon Greenfield, M.D., of the New England Medical Center, and others.

The second AHCPR-funded study finds that selected patients suffering from chest pain can avoid a costly hospital admission and be treated just as effectively when accelerated diagnostic protocols (ADPs) are used in an observational unit of an Emergency Department (ED). This randomized controlled trial, entitled "Costs of an Emergency Department-based Accelerated Diagnostic Protocol vs. Hospitalization in Patients with Chest Pain," was conducted by Rebecca Roberts, M.D. and colleagues at Chicago's Cook County Hospital/Rush University.

Editor's Note: To arrange interviews with Dr. Hayward, please contact Dave Wilkins or Pete Barkey, University of Michigan Medical Center Public Relations, at (313) 764-2220. To arrange interviews with Dr. Greenfield, please contact Melissa McPherson or Catherine Bromberg, New England Medical Center External Affairs, at (617) 636-0200. To arrange interviews with Dr. Roberts, please contact Don Rashid at Cook County Public Affairs (312) 633-7401.

For additional information, contact AHCPR Public Affairs: Karen Carp, (301) 427-1858 ( or Salina Prasad, (301) 427-1864 (

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