Our Newsletter

Oregon Clinic Web News

VolumeII, January 2010

 

1. American Diabetes Association has approved testing of hemoglobin A₁c for diagnosis of diabetes mellitus.  If your hemoglobin A₁c is 5.7-6.4, you are considered to have pre-diabetes and if it is above 6.5% that is thought to be consistent with a diagnosis of diabetes.  It is to be noted that the diagnosis of pre-diabetes and diabetes prior to this was based on fasting blood sugar.  If your fasting blood sugar is above 126, you have diabetes and if your fasting blood sugar is between 105 and 125, you have pre-diabetes. 

 

Oregon Clinic offers hemoglobin A₁c tests, which can be done promptly and you would know its results instantly.  So, if there is a suspicion that you have symptoms of diabetes like frequent urination, increased appetite or frequent skin infections, please mention to your Oregon Clinic physician or nurse practitioner and you can be promptly checked for hemoglobin A₁c.

 

2. There has been lot of controversy regarding mammograms for early detection of breast cancer.  These are the recommendations for American College of Radiology and The Society of Breast Imaging.  Their recommendations are as follows.

 

• Women who have average risk for breast cancer should receive annual mammography beginning at age 40.

• Women who carry BRCA mutations or who are untested first degree relatives of a BRCA mutation carrier should have annual mammography and annual MRIs starting by age 30, but not before 25. 

• Women with a 20% or more lifetime risk for breast cancer, based on family history, they should have annual mammography and annual MRI starting by age 30, but not before age 25 or 10 years before the age of their youngest affected relative, which ever is later. 

Oregon Clinic Web News

Volume II, January 2010 (continued)

• Women with dense breast as the only risk factor may benefit from the addition of ultrasound to mammography for cancer detection. 

ACR and SBI, that is American College of Radiology and The Society of Breast Imaging, recommendations are based on pre-reviewed published data and expert consensus.  It is to be noted that they did not take into account US Preventive Services Task Force method of potential harms from screening.

               

3. If your blood pressure is high and your physician has difficulty controlling it, consider cutting out the “salt”.  This study was published in Hypertension, September 2009, volume 54, page 475.  These patients were thought to have resistant hypertension despite use of three or more antihypertensive agents.  Twelve adults completed the study.  The participants took an average of 3.4 antihypertensive medications.  One group was given a low-sodium diet of 1.25 gm sodium per day and the second group was given 6.23 gm of sodium per day.  The patients had monitoring of the urine sodium to confirm that they were actually following the low salt regimen.  The patients who were on a low salt diet, their systolic blood pressure was lower by 23 mm of mercury and diastolic was lower by 9 mm of mercury.  This small study shows that if you have had trouble controlling your blood pressure, the first and foremost thing is to watch your salt intake and reduce it to 1.25 gm per day if possible.  It is to be noted that Oregon Clinic offers dietary counseling.  We have a registered dietitian with a Master’s degree who can counsel you regarding your efforts to reduce salt intake. 

4. Screening for aortic aneurysm. 

All men between the age of 65 and 75, who have a history of smoking and hypertension, are candidates for a onetime screening for aortic aneurysm and this is done by ultrasound of the abdomen and this test is also offered by Oregon Clinic.