American family physician
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Hearing loss is a prevalent, chronic condition in the United States; it is often gradual and progressive and is underreported by patients and undertreated by physicians. The impaired ability to effectively hear and communicate may result in negative emotional, cognitive, economic, and social consequences for individuals and may pose a safety risk. Questionnaires and smartphone apps are available to help identify and evaluate self-perceived hearing loss. ⋯ Medicare Parts A and B do not pay for hearing aids, although some Medicare Advantage (Part C) or supplemental plans may provide insurance coverage for hearing aids. Less expensive, over-the-counter hearing aids may help mild to moderate hearing loss. Family physicians should counsel patients on the importance of protecting their hearing.
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American family physician · Apr 2024
ReviewManagement of Type 2 Diabetes Mellitus With Noninsulin Pharmacotherapy.
Type 2 diabetes mellitus is a chronic disease that is increasing in global prevalence. An individualized approach to pharmacotherapy should consider costs, benefits beyond glucose control, and adverse events. Metformin is the first-line therapy due to its low cost and effectiveness. ⋯ Glucagon-like peptide-1 receptor agonists are contraindicated in patients with active multiple endocrine neoplasia type 2 or a personal or family history of medullary thyroid carcinoma; adverse effects include gastrointestinal upset and pancreatitis. Dipeptidyl-peptidase-4 inhibitors have a low risk of hypoglycemia but may increase the risk of pancreatitis and require a renal dose adjustment. Public and private programs to increase access to newer hypoglycemic medications are increasing; however, there are limitations to access, particularly for uninsured and underinsured people.
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American family physician · Apr 2024
Primary Care Access in Areas of the United States With Aging Populations.
The percentage of U. S. residents 65 years and older was 17% in 2020, and this number is expected to rise due to the aging of the baby boomer generation.1Although life expectancy fell between 2020 and 2021, the proportion of U. ⋯ Domestic migration (U. S. residents moving within the country) of this retirement-aged population further strains the primary care workforce in underserved areas.