Family Practice News articles from December 2007

Family Practice News archives from December 2007

Metrics chart plan for medical home.(Practice Trends)
December 1, 2007... [ILLUSTRATION OMITTED] WASHINGTON -- Medical home advocates hope a new set of metrics will help primary care physicians move closer to implementing this model of care. The metrics assess how patient centered an office-based practice is...

Simple algorithm boosts high blood pressure control: goal reached in 65% vs. 53% patients.(News)
December 1, 2007... ORLANDO -- A simple hypertension-treatment algorithm was more effective than was guideline-led practice for controlling blood pressure in a controlled study involving 45 family practices in southern Ontario. The cornerstone of the algorithm...

Gastroprotection gap spells disaster for arthritis patients.(News)
December 1, 2007... BOSTON -- Following years of decline, the rate of stomach complications in arthritis patients taking nonsteroidal anti-inflammatory drugs appears to be on the rise as a result of a widening gap between NSAID prescriptions and therapies that...

Who pays for personal health care?(VITAL SIGNS)(Table)(Survey)(Brief article)
December 1, 2007... Who Pays for Personal Health Care? Private health insurance 36% Medicare 20% Medicaid 17% Out of pocket 15% Other public * 8% Other private 4% Total...

Preventive care gains useful how-to guidelines.(News)(Guidelines for Health Supervision of Infants, Children, and Adolescents)
December 1, 2007... The guidelines for well-child visits and anticipatory guidance just got simpler. For the first time, one set of guidelines will replace three separate documents from three different organizations, with the release of the third edition of...

ESA labels show risks for cancer, kidney patients: specific recommendations for dosing adjustments and hemoglobin monitoring are established.(News)
December 1, 2007... The Food and Drug Administration approved major changes to the labels of erythropoiesis-stimulating agents, addressing serious risks that have been associated with these drugs in patients with cancer or chronic renal failure. The FDA...

Merck offers $4.85 billion payout; FDA reform underway.(News)
December 1, 2007... Merck & Co. has announced that it will pay $4.85 billion into a fund to settle claims that its cyclooxygenase-2 inhibitor rofecoxib (Vioxx) was responsible for causing myocardial infarction and stroke in patients who took the drug for pain. ...

Obstetric care shortage worsens in Oregon.(News)(Survey)
December 1, 2007... VANCOUVER, B.C. -- Nearly a quarter of all trained obstetric providers stopped delivering babies in Oregon between 2002 and 2006, despite the introduction of malpractice premium subsidies midway through that period, Dr. Ariel K. Smits reported...

Myocardial infarction warning added to Avandia's black box.(News)
December 1, 2007... A warning about the potential increased risk for myocardial infarction associated with rosiglitazone has been added to the existing black box warning for the antidiabetic agent, reflecting the results of the widely publicized meta-analysis of...

SCHIP's fate unclear as Congress, Bush tussle: earlier, SCHIP reauthorization seemed like a foregone conclusion. Now states are slated to cut enrollment.(News)
December 1, 2007... With the end of the year drawing near--and Congress past due to adjourn--the fate of the reauthorization of the State Children's Health Insurance Plan was unclear. SCHIP received one reprieve when Congress approved a continuing resolution...

Guidelines, tool kit help with universal autism screening.(News)
December 1, 2007... SAN FRANCISCO -- New clinical guidelines advocate surveillance for signs of autism at each well-child visit before 18 months of age and screening for autism at the 18- and 24-month checkups. "I know what you're thinking--'Aah! Another thing...

Bridging the gastroprotection gap.(Guest Editorial)(Editorial)
December 1, 2007... The proportion of patients taking nonsteroidal anti-inflammatory agents without gastroprotection is a problem not just in California, but on a national scale. In my practice, where I have a lot of con tact with geriatric patients, I've...

All roads meet in public health system.(Guest Editorial)
December 1, 2007... Access to first-rate public health services is essential for overall health quality and outcomes, and also for individuals and society to be productive. The Mexican sociologist Dr. Julio Frenk wrote: "Health is a crossroad. It is where...

Correction.(Opinion)(Correction notice)
December 1, 2007... In "Specialists Reject CT for Lung Cancer Screening" (Nov. 1, 2007, p. 41), we incorrectly reported that Dr. James L. Mulshine participates in the International Early Lung Cancer Action Program. Also, the statement that General Electric Co. has...

MDCT scores in trial, but critics still wary.(Cardiovascular Medicine)(multidetector computed tomography)
December 1, 2007... ORLANDO -- CT angiography remains controversial after a report on the diagnostic accuracy of multidetector CT measured in 316 patients. Noninvasive multidetector CT (MDCT) angiography had a 91% positive predictive value and an 83% negative...

Venous thromboembolism.(Clinical Guidelines For Family Physicians)
December 1, 2007... Venous thromboembolic disease includes pulmonary embolus and deep vein thrombosis. The annual incidence of the disease in the United States is 600,000 cases. These new recommendations review the diagnosis and treatment of pulmonary embolus and...

Childhood trauma raises risk of adult CHD and depression.(Cardiovascular Medicine)
December 1, 2007... VIENNA -- Childhood trauma was an independent predictor of coronary heart disease and major depression later in life in a study with 360 men. "Childhood trauma can have important consequences, but it is a risk factor that physicians don't...

CVD affects about 6 million U.S. Diabetics.(Cardiovascular Medicine)
December 1, 2007... Cardiovascular disease affected approximately 6 million diabetic adults aged 35 years and older in the United States in 2005, according to the Centers for Disease Control and Prevention. Reseachers at the CDC analyzed data from the National...

No clear benefit from rosuvastatin for heart failure patients.(Cardiovascular Medicine)
December 1, 2007... Treatment with rosuvastatin in older patients with moderate to severe chronic ischemic heart failure due to left ventricular systohc dysfunction did not reduce the risk of death from cardiovascular causes or the rate of nonfatal myocardial...

Heart failure patients less responsive to aspirin.(Cardiovascular Medicine)
December 1, 2007... ORLANDO -- About 10% of patients who presented to a hospital emergency department with chest pain and suspected acute coronary syndrome had platelets that were nonresponsive to aspirin, in a study with about 1,000 patients. The prevalence...

Preeclampsia, CVD linked; prevention urged.(Cardiovascular Medicine)
December 1, 2007... Women who have had pre-eclampsia are at increased risk of cardiovascular disease later in life, suggesting that they should be targeted for primary prevention, according to a British review. "The underlying link between pre-eclampsia and...

Device lowers weight, glucose in type 2 diabetes.(Metabolic Disorders)
December 1, 2007... AMSTERDAM -- A novel gastric electrical stimulation device can potentially improve glucose levels and induce weight loss in obese patients with type 2 diabetes on oral antihyperglycemic therapy, Dr. Christoph Rosak said in a poster presentation...

Treat pregnant women with a history of GDM.(Metabolic Disorders)(gestational diabetes mellitus)
December 1, 2007... AMSTERDAM -- Treating all women with previous gestational diabetes mellitus for GDM early in their subsequent pregnancies--without rescreening them--is likely to improve maternal and fetal outcomes, Dr. Christina S. Cotzias said at the annual...

Atypical antipsychotics tied to adrenal issues.(Metabolic Disorders)
December 1, 2007... NEW ORLEANS -- It is important to recognize the potential for atypical antipsychotics to cause adrenal insufficiency to ensure that the condition is managed appropriately, according to Dr. Violeta Tan and Dr. Natalie Rasgon. They described...

Fenofibrate cuts retinopathy in diabetic patients: those who were treated with the drug also had less progression of albuminuria and fewer amputations.(Metabolic Disorders)
December 1, 2007... ORLANDO -- Treatment with fenofibrate led to a substantial drop in the need for laser treatments for retinopathy in a controlled trial of nearly 10,000 patients with type 2 diabetes. Physicians should "consider using fenofibrate on all...

40 mg of lisinopril daily is ideal for diabetic nephropathy.(Metabolic Disorders)
December 1, 2007... AMSTERDAM -- In type 1 diabetic patients with diabetic nephropathy, 40 mg/day of lisinoprll appears to be the ideal dose for renoprotection, Dr. Katrine J. Schjoedt said in a poster presentation at the annual meeting of the European Association...

Cancer patients miss shots in PCP-specialist gap.(Infectious Diseases)
December 1, 2007... Los ANGELES -- Primary care physicians cannot assume cancer patients are receiving influenza or pneumonia vaccinations while in the care of oncology specialists. When surveyed at the University of Pennsylvania in Philadelphia, a third of...

Flu vaccine effective despite anti-TNF therapy.(Infectious Diseases)
December 1, 2007... Patients taking anti-tumor necrosis factor-[alpha] medications show somewhat impaired antibody response to influenza vaccination, but there is no decrease in the proportion of patients achieving a protective titer. A study, by Dr. L.B.S....

Flu shot rates are low among high-risk teens.(Infectious Diseases)
December 1, 2007... SAN DIEGO -- The number of adolescents with asthma and other high-risk conditions who received the influenza vaccine increased between 1992 and 2002, but the coverage remains poor at about 15% overall, results from a large health maintenance...

ACIP clarifies its suggestions for PCV7 catch-up.(Infectious Diseases)(Advisory Committee on Immunization Practices)(pneumococcal conjugate vaccine)(Brief article)
December 1, 2007... ATLANTA -- Healthy children between 2 and 5 years of age who have been incompletely vaccinated against pneumococcal disease should receive one dose of 7-valent pneumococcal conjugate vaccine, the Centers for Disease Control and Prevention's...

STD rates continue to increase in select groups.(Infectious Diseases)(sexually transmitted diseases)
December 1, 2007... Rates of chlamydia, gonorrhea, and syphilis increased in the United tares during the past year and continued recent upward trends, according to a report from the Centers for Disease Control and Prevention "Young women, racial and ethnic...

Two- and three-dose PCV7 schedules aren't equivalent.(Infectious Diseases)(pneumococcal conjugate vaccine)
December 1, 2007... CHICAGO -- Trimming the septivalent pneumococcal conjugate vaccine schedule from three prebooster doses to two may leave children more vulnerable to infection, according to data presented at the annual Interscience Conference on Antimicrobial...

Risk-based SCC subtype classification is proposed.(Skin Disorders)(squamous cell carcinoma)
December 1, 2007... MONTEREY, CALIF. -- Cutaneous squamous cell carcinoma can take many forms, with vastly different biologic behaviors and risk profiles. Yet, "with relatively few exceptions, they have a tendency to simply be lumped by the nondermatologist...

Tracking actinic keratoses: here, there, nowhere.(Skin Disorders)
December 1, 2007... AMSTERDAM -- The natural history of actinic keratoses involves high turnover and far greater lability than generally recognized, according to a first-of-its-kind study. "When you count three or four AKs on a person at time zero and come...

Social rhythm therapy prevents bipolar episodes.(Mental Health)
December 1, 2007... VIENNA -- A psychosocial intervention aimed at instilling greater regularity of daily routines in patients with bipolar disorder effectively protects against recurrences of both mania and depression, Ellen Frank, Ph.D., said at the annual...

Tools aim to streamline child mental services.(Mental Health)
December 1, 2007... SAN FRANCISCO -- There's no quick way around the barriers faced by children who need mental health care, so pediatricians are developing a string of strategies to improve delivery of mental health services, Dr. Jane M. Foy said. These...

Breast cancer risk high in Hodgkin's survivors.(Women's Health)
December 1, 2007... LOS ANGELES -- Increased risk of breast cancer after successful treatment for Hodgkin's lymphoma "definitely exists," and is very much a matter of time, according to a researcher who reviewed records for 248 women cured of Hodgkin's lymphoma...

Increasing folic acid supplementation.(Drugs, Pregnancy, And Lactation)
December 1, 2007... This month, the Society of Obstetricians and Gynecologists of Canada is releasing new guidelines on folic acid supplementation in pregnant women, recommending prenatal vitamins that include 5 mg of folate in certain patients. Unless providers...

Ginger, vitamin [B.sub.6] ease nausea in pregnancy.(Women's Health)
December 1, 2007... SAN FRANCISCO -- Multiple clinical trials have shown that both ginger and vitamin [B.sub.6] can safely help reduce the nausea and vomiting of "morning sickness" in pregnancy. Cathi Dennehy, Pharm.D., reviewed the evidence for the efficacy...

Bazedoxifene may not harm the endometrium.(Women's Health)(Brief article)
December 1, 2007... Bazedoxifene, a novel selective estrogen-receptor modulator, is as safe as placebo in terms of effects on the endometrium and promises to be an excellent new therapy for the prevention and treatment of postmenopausal osteoporosis, Dr. David F....

Combo asthma therapies may deliver same control.(Pulmonary Medicine)
December 1, 2007... CHICAGO -- Equivalent or better asthma control using combination therapy may be achieved with less budesonide/formoterol than with fluticasone/salmeterol in the first year of use, Samy Suissa, Ph.D., said at the annual meeting of the American...

Infliximab cuts ulcerative colitis colectomy rate.(Digestive Disorders)(Clinical report)
December 1, 2007... PHILADELPHIA -- Patients with moderate to severe ulcerative colitis treated with infliximab had their colectomy rate cut by more than a third during the first year of treatment, compared with control patients, according to a review of more than...

Number of adenomas, rather than size, are predictors of colonic recurrence risk.(Digestive Disorders)
December 1, 2007... PHILADELPHIA -- A finding of three or more adenomas on colonoscopy was the strongest predictor of identifying high-risk individuals on follow-up colonoscopy in a review of 800 patients with colonic adenomas identified during their baseline...

Mesalamine, folic acid cut cancer risk in IBD.(Digestive Disorders)
December 1, 2007... PHILADELPHIA -- Treatment with either folic acid or mesalamine was linked to about a 90% reduction in the incidence of colorectal cancer in a case-control study including 48 patients with inflammatory bowel disease. Both agents "appear to...

Methotrexate not best option for psoriatic arthritis.(Musculoskeletal Disorders)
December 1, 2007... BOSTON -- Rheumatologists need to rethink their reflex to prescribe methotrexate for psoriatic arthritis given mounting data showing that anti-tumor necrosis factor agents are more effective for this indication, Dr. Christopher Ritchlin said at...

Combo helps early RA patients attain remission.(Musculoskeletal Disorders)
December 1, 2007... BOSTON -- Half of patients with early rheumatoid arthritis treated with a combination of etanercept and methotrexate achieved disease remission within 1 year in the first major trial to use remission as the primary end point, Dr. Paul Emery...

Disability in obese elderly is rising, not declining.(Obesity)
December 1, 2007... Some types of disability are increasing in older obese Americans, even though recent improvements in cardiovascular health care have reduced the risk of disability in older normal-weight people, according to researchers at the University of...

Low-carb diet may be best in type 2.(Obesity)
December 1, 2007... NEW ORLEANS -- A low-carbohydrate diet, which used to be the only treatment for diabetes before the advent of insulin, may turn out to be the preferred diet for overweight individuals with type 2 diabetes, researchers said at the annual meeting...

Vascular dysfunction and preeclampsia.(Clinical Capsules)(Brief article)
December 1, 2007... Women with type 1 diabetes who are going to develop preeclampsia during pregnancy have signs of vascular dysfunction early in the pregnancy, according to Danish researchers who followed 83 women. The researchers measured a number of markers...

Racial disparities in diabetes control.(Clinical Capsules)(Brief article)
December 1, 2007... The disparity in glycemic control between white Americans and those of other ethnic groups may be strongly related to unexplored issues such as medication nonadherence and diabetes-related emotional stress, according to Dr. Michele Heisler of...

Depression erodes health scores.(Clinical Capsules)(Survey)(Brief article)
December 1, 2007... Depression is more disabling than four other chronic conditions--angina, arthritis, asthma, and diabetes, reported Saba Moussavi, Ph.D., and colleagues in the World Health Organization's Department of Measurement and Health Information Systems....

CKD more pervasive than thought, and increasing.(Clinical Rounds)
December 1, 2007... The prevalence of chronic kidney disease in the general U.S. population is higher than was previously estimated and has increased in recent years, reported Dr. Josef Coresh of Johns Hopkins University, Baltimore, and his associates. With...

RAS blockade can help reduce cardiac, renal events in kidney disease patients.(Clinical Rounds)
December 1, 2007... CHICAGO -- Routine use of renin angiotensin system blockers is indicated in patients with chronic kidney disease as part of a strategy to reduce cardiovascular and renal events, Dr. Matthew Weir said at the annual meeting of the American...

Fish oil improves heart risk markers in dialysis patients.(Clinical Rounds)
December 1, 2007... ORLANDO -- Giving hemodialysis patients oral fish oil supplements boosts their red blood cell fatty acid levels and may afford them protection against cardiovascular disease by improving serum levels of cardiovascular risk markers, according to...

Kucinich is lone candidate for a single-payer system.(Practice Trends)
December 1, 2007... WASHINGT0N -- Anyone who asks Rep. Dennis Kucinich (D-Ohio) about health care policy should be prepared for the conversation to evolve into other areas--such as the Iraq war. "Health care spending does not occur in a vacuum," Rep. Kucinich...

Work-based coverage cuts take toll.(Policy & Practice)(Brief article)
December 1, 2007... The number of uninsured Americans rose by nearly 9 million, from 38 million in 2000 to 47 million in 2006, mostly as a result of a decline in employer-provided health coverage for workers and their families, according to an analysis by the...

Patent losses choke drug sales.(Policy & Practice)
December 1, 2007... The growth of pharmaceutical sales in the United States is expected to increase by 4%-5% next year, a historic low, according to a report by IMS Health Inc. The Norwalk, Conn.-based research firm attributed the slowdown to a leveling of the...

Bill aims to boost OTC oversight.(Policy & Practice)(over-the-counter )(Brief article)
December 1, 2007... Another bill introduced by Rep. Waxman and Sen. Kennedy, along with Rep. Tom Allen (D-Maine), would give the FDA the authority to quickly amend or appeal over-the-counter drug monographs without being required to pursue notice and comment...

Data on elderly glossed over.(Policy & Practice)(Brief article)
December 1, 2007... Food and Drug Administration regulations for drug makers conducting clinical trials encourage the inclusion of elderly participants and the reporting of data by age, but the agency is not effective in getting its medical officers to include...

Depression no. 2 in disability days.(Policy & Practice)(Brief article)
December 1, 2007... Major depression accounts for the second-largest number of days lost to disability in the United States--387 million days a year at the population level, second only to back and neck pain, at 1.2 billion days--according to a study by Harvard...

Pregnant women eschew meds.(Policy & Practice)
December 1, 2007... A minority of women believe it is safe to take depression medication while they are pregnant, according to a survey by the Society for Women's Health Research. The survey of 1,000 women was conducted by telephone in October; 500 family...

Beware of direct-to-consumer testing.(Genomic Medicine)
December 1, 2007... The American consumer seems to be growing weary of TV advertisements for erectile dysfunction drugs. Yet the adverts have not gone away. No surprise--they sell product, and often, to individuals who really don't need the medications. Now get...

EHR alerts boost vaccination rates in urban kids.(Practice Trends)
December 1, 2007... Building clinical alerts and recommendations into electronic health records significantly improved immunization rates for inner-city children in a primary care network affiliated with the Children's Hospital of Philadelphia. During the...

Should you do this deal?(The Office)
December 1, 2007... If you've ever wondered whether you should buy a DXA machine or start offering botox in your practice, read on: Learning how to calculate the net present value of that venture would go a long way toward helping you figure out if it's truly a...

Paging Dr. Fabio.(Indications)(Brief article)
December 1, 2007... The Bureau of Indications knows truth is stranger than fiction. That's why we love a new study exploring the plot of medical romance novels for clues about "the romantic possibilities of primary care settings and the apparent inevitability of...

Love the one you're with.(Indications)(Brief article)
December 1, 2007... Manipulating a gene in female nematode worms resulted in their being attracted to other females, wrote University of Utah, Salt Lake City, researchers In Current Biology. Of course, the female worms have a big secret: They aren't really...

North Pole is stressful, study finds.(Indications)(Brief article)
December 1, 2007... People on polar expeditions face a great many challenges. They can be eaten by a bear or get stuck in a blizzard. "An understanding of these demands is of great importance for prevention and treatment of morbidity and mortality related to poor...

The most wonderful time of the year.(Indications)(Brief article)
December 1, 2007... Happy holidays from the American Heart Association! On its Web site, the AHA offers some practical ways to have a great holiday season that we're sure you'll have no trouble following. Tips include don't overindulge on holiday goodies (such as...

Needling resolved calcific tendonitis.(Musculoskeletal Disorders)
December 15, 2007... [ILLUSTRATION OMITTED] An ultrasound-directed nonrgical needling techique reduced pain and improved mobility in 95% of adults with calcific tendonitis of the shoulder. "We do nothing but accelerate the natural process," which can...

DEA relaxes rules on prescribing schedule II drugs: three scrips for 90 days are allowed.(Drug Enforcement Administration)
December 15, 2007... In a reversal, the Drug Enforcement Administration now allow physicians to write up to three prescriptions for a 90day supply of schedule II Controlled substances. The final rule, published last month, is viewed as a victory by pain...

Diclofenac gel eased hand osteoarthritis pain intensity.(Musculoskeletal Disorders)
December 15, 2007... Boston -- Topical administration of diclofenac sodium gel was associated with statistically significant and clinically meaningful improvements in symptoms of hand osteoarthritis in a multicenter, double-blind trial, Dr. Roy Airman reported at...

Activity limitations caused by chronic health conditions in adults aged 45-54 years (per 1,000 population).(VITAL SIGNS)(Table)(Brief article)
December 15, 2007... Arthritis and other 55.8 musculoskeletal conditions Heart and other 25.3 circulatory, conditions Mental illness 20.7 Diabetes 13.2 Fractures or joint injury 12.4...

Cancer detection enhanced, but at a price.(News)
December 15, 2007... Chicago -- Supplemental ultrasound breast screening significantly increased the number of cancers detected, but resulted in a substantial number of false-positive findings in a multicenter study of 2,637 women at high risk for breast cancer....

Label changes likely for Oseltamivir, Zanamivir.(News)
December 15, 2007... GAITHERSBURG, MD. -- Prompted by concerns about an association between antiviral drugs and neuropsychiatric events in patients with influenza, a dosely divided Food and Drug Administration advisory panel voted last month to recommend revised...

Alert issued on drug for helping smokers quit.(NEWS FROM THE FDS)
December 15, 2007... The Food and Drug Administration has issued an alert about postmarketing reports of suicidal thoughts, aggressive and erratic behavior, and drowsiness associated with varenicline, the smoking cessation drug marketed as Chantix. A notice...

Intranasal desmopressin linked to severe hyponatremia, seizures.(NEWS FROM THE FDS)
December 15, 2007... BY ELIZABETH MECHCATIE Senior Writer Intranasal formulations of desmopressin acetate are no longer indicated for treating primary nocturnal enuresis because of the risk of severe hyponatremia and seizures associated with these products when...

FDA drafts new conflict rules, voting procedures for advisers.(News)(Food and Drug Administration)
December 15, 2007... The Food and Drug Administration has said it wants to require more public disclosure of advisory committee members' conflicts of interest and the information will be available on a new Web site. The agency also said it will post more data...

Guidelines urge caution on thiazolidinediones.(News)
December 15, 2007... In light of new information regarding thiazolidinediones, the American Diabetes Association and the European Association for the Study of Diabetes have updated their previous diabetes treatment guidelines to urge "greater caution" in the use of...

E-prescribing standards proposed for medicare.(News)
December 15, 2007... The Health and Human Services department has proposed federal e-prescribing standards to be used for Medicare participating physicians, pharmacists, and software vendors. The proposal was issued last month; comments are being accepted...

Preventing gun violence: we must act.(Guest Editorial)
December 15, 2007... Working in a trauma center at Loyola, I see gunshot victims often--I see the devastation that guns cause. As I was working with a medical student on a Grand Rounds presentation on gunshot violence, I came across some of the following...

Population matters in lung screening.(Letters)(Letter to the editor)
December 15, 2007... Without belaboring the controversy, I would suggest that the problem with CT screening for lung cancer is with the patient study mix ("Specialists Reject CT for Lung Cancer Screening," Nov. 1, 2007, p. 41). In our area of...

Measuring prolotherapy's effectiveness.(Letters)(Letter to the editor)
December 15, 2007... The treatment of chronic back pain with prolotherapy is an excellent choice for examination with a Cochrane review ("Prolotherapy for Chronic Back Pain," Alternative Medicine, Oct. 15, 2007, p. 39). However, the studies that are mentioned...

Being a single dad is ongoing struggle.(Letters)(Letter to the editor)
December 15, 2007... I became a single father of a bright young boy in the early 1990s ("Navigating Life as a Single Father." The Rest of Your Life, Oct. 15, 2007, p. 46). I felt displaced, alone, and of low worth as I struggled to see and spend time with my...

Easier formula, similar results.(Letters)(Letter to the editor)
December 15, 2007... For years, I have been taking the hemoglobin [A.sub.1c] subtracting 2, then multiplying this number by 30 to get my estimated blood glucose level ("Formula Links Hb[A.sub.1c] to Average Plasma Glucose," Nov. 1, 2007, p. 17). So for an...