JAMA : the journal of the American Medical Association
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Although the association between parental coronary artery disease (CAD) and its risk factors in the offspring is known, the timing and the course of development of risk factors from childhood to adulthood in the offspring is not known. ⋯ Offspring of parents with early CAD were overweight beginning in childhood and developed an adverse cardiovascular risk factor profile at an increased rate. These observations have important implications for prevention and intervention.
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Comparative Study
Alcohol-related injury death and alcohol availability in remote Alaska.
Injury is a major public health problem in Alaska, and alcohol consumption and injury death are associated. ⋯ Although insufficient data existed to adjust for the effects of all potential confounders, residence in a wet village was associated with alcohol-related injury death among Alaska Native residents of remote Alaska villages. These findings indicate that measures limiting access to alcoholic beverages in this region may decrease alcohol-related injury deaths.
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Although experimental studies show that insulin therapy can be safe and efficacious in improving glycemic control in type 2 diabetes under optimal conditions (ie, using patient volunteers with close monitoring under strict study protocols), little is known about its effectiveness, complication rates, and associated resource utilization in actual clinical practice. ⋯ For patients with type 2 diabetes who were cared for by generalist physicians, starting insulin therapy was generally safe and effective in achieving moderate glycemic control in patients who initially had poor glycemic control. However, insulin therapy was associated with increases in resource use and was rarely effective in achieving tight glycemic control, even for those with moderate control.