CLIPPER • THURSDAY, AUG. 18, 2011
Health A13
FDA seeks oversight of electronic medical applications BY SAMANTHA STEPP
Clipper Intern There’s an app for almost everything these days. For $1, $2 or for free, you can turn an iPhone, Blackberry or Android into a GPS, a pedometer, a boombox, a flute or…an ultrasound machine? Believe it or not, the technology world has come out with a wide range of health-related applications aimed specifically at medical professionals, some of them meant to augment or even replace the bulky machinery that normally crowd a doctor’s office. These applications range from encyclopedia-like disease and medication information aggregators like Medscape to healthand-diet recommenders like Lose It to applications like SonoAccess, aimed at helping doctors and nurses perform high-level, on-the-job tasks like ultrasounds. The attitude in the medical world seems to be one of open curiosity; experts generally regard these applications as interesting and potentially very useful rather than unprofessional. Brian Rodgers, D.O. of
MEDICAL APPLICATIONS for smartphones and other electronic devices could help the medical community, but the FDA wants to make sure patients aren’t incorrectly using the devices to misdiagnose themselves. Photo stock Bountiful Family HealthCare said he would “love” to have an app, such as a heart monitor app, that would allow him to assess a patient’s condition. “This would make my job easier,” said Rodgers. “At the same time, I would also have to know the limits of the application. I would need to use it within those safe and approved limits.” The medical world at large agrees, and this is why the FDA recently announced its plan to put regulations in place for all
medical-related applications, or at least the ones aimed at helping medical professionals do their jobs. Just as many of the current applications are meant to reinforce standard equipment already in place, the regulations for medical smartphone applications will probably simply add to the regulations already in place for medical devices. The task is no easy one – according to the latest data from the Associated Press, there are almost 17,000 medical-related
smartphone applications out there. That’s a lot to classify and oversee. Because of the enormity of their undertaking, the FDA is not going to dictate specific regulations for each type of application; rather the blanket regulations being proposed focus more on requiring all application manufacturers to submit their applications to the FDA for approval before making them available to the wider app marketplace. For now, the most useful
advantage apps provide to medical professionals is immediate, on-hand information. “I can have access to a whole medical library through my smart phone,” said Rodgers, but emphasized that in the end, patients “know their bodies best” and that a doctor’s prime responsibility remained putting the information “into context.” If you’re not a medical professional, and looking for a cool and cheap health-related smartphone app that doesn’t involve performing an ultrasound or an X-ray, check these out: • iScale (iPhone, $4.99): This colorful, simple app helps you keep track of what you eat during the day. Its database includes the calorie counts of thousands of different foods, helping you build meals that fit into your calorie budget as you try to lose weight. • CardioTrainer + Racing (Android, $2.99): This highly-rated app helps take the place of a running trainer. Take it with you on your route and a simulated voice will let you know how fast you’re running compared to how you did yesterday. You can also
map out your route on a satellite map and measure how many calories you’ve burned on your run. • Gym Technik 1.2 (Blackberry, FREE): Plan and keep track of your workout routines on this free app from Gym Technik. Customize a workout specifically suited to you using the app’s database of 45 exercises for arms, 23 for the back, and eight cardio exercises, including instructions for how to do them. • Fooducate (iPhone, FREE): Scan groceries and get health information on them, right in the store. With more than 200,000 UPCS on file, Fooducate helps you choose groceries by giving each one an A through F grade and providing helpful tips such as: “Look out! Not 100% whole grain” and “Controversial additive BHT is present.” • My Tracks (Android, FREE): A built-in GPS sensor allows this app to track your exact location as you run, walk, hike or bike. Look back when you’re done and see the route you took on Google Maps, as well as a graph of your changes in elevation, your speed and your pace.
Muscle mass and diabetes prevention Davis County BY SAMANTHA STEPP
Clipper Intern There is good news for people who are at risk for type 2 diabetes, but have trouble losing weight: new research suggests building muscle may be just as important to decreased insulin resistance as losing fat. A recent study at UCLA looked at more than 13,000 adults representing a wide range of shapes and sizes, and found that for each 10 percent increase in SMI (skeletal muscle index – the ratio of muscle mass to total body weight), there was a corresponding 11 percent decrease in insulin resistance and 12 percent reduction in pre-diabetes, a condition characterized by high levels of glucose in the blood. In this case, SMI was a better indicator of insulin resistance and pre-diabetes than BMI or waist circumference, measures of obesity doctors typically use as warning flags for diabetes. Insulin acts like a key to let glucose, or blood sugar, into the body’s cells. Sometimes the body does not produce enough insulin or insulin is not working properly, which causes glucose to build up in the blood and the person to become diabetic. “Muscles use glucose for energy, and a person with more muscle will
CURRENT STUDY SUGGESTS muscle mass is a better predictor of glucose levels than fat. Living a healthy lifestyle overall is most important. Photo stock utilize more glucose,” said Vivian Giles, M.P.H., Health Program Specialist for the Utah Department of Health Diabetes Prevention and Control Program. “Excess body fat increases insulin resistance.” The current study, however, suggests that muscle mass is a better predictor of glucose levels than fat. It is important to note the UCLA study was cross-sectional rather than interventional, meaning it only determined that there was a relationship between muscle mass and insulin resistance. There is no evidence yet as to whether increas-
ing one’s muscle mass actually decreases one’s chances of developing pre-diabetes. Moreover, said Giles, other risk factors, such as genetics, eating a high-calorie diet, and not being physically active, seem to have the greatest impact on one’s risk for developing diabetes. “Being obese seems to be the greatest indicator of a person’s risk for type 2 diabetes,” said Giles. “People with heart disease often have diabetes, so if you have the risk factors for heart disease (such as high blood pressure), be sure to get regular diabetes screenings from your health
care provider.” The researchers at UCLA are now looking to perform a similar analysis on a larger data set. However, even if their results come back more conclusive and solid, Giles predicts it will not change the way doctors screen for diabetes or treat their pre-diabetic patients. First of all, the training and equipment required to conduct an SMI measurement costs much more than taking a BMI measurement, which is a simple weight-to-height ratio. Second of all, the evidence garnered in this study does not change what the medical world already knows, such as the fact that someone with a waist measurement of 35 inches or more is at risk for type 2 diabetes. In the end, living a healthy lifestyle overall is more important than simply gaining muscle mass. “Considering that an estimated 79 million Americans have pre-diabetes, health care providers need to stress the importance of healthy lifestyles to all of their patients,” said Giles. “Lifestyle factors such as eating a balanced diet, being physically active, getting adequate sleep, and managing stress are important for all of us — not just those who have been told they have prediabetes.”
named lowest in health care costs Davis and Weber Counties have been identified as the least-expensive health care markets in the nation. That’s based on a study conducted by Thomson Reuters, a business information and news service organization. The Ogden/Clearfield Metropolitan Statistical Area includes both counties, and is a federal designation on which study data were collected. It listed average healthcare costs at $2,623 in annual spending. Salt Lake City came in at 8th place at $2,979. The highest average spending occurred in Anderson, Ind., at nearly three-times as much, $7,231. Spokespersons Tiffany Burnett from Lakeview Hospital and Diane Townsend from Davis Hospital were excited at
the news. “Mike Jensen (Davis Hospital CEO) liked hearing the news and wasn’t surprised by the findings. We all work very hard to provide exceptional health care at an affordable cost. It’s a great reflection of our community,” Townsend said. “This study is very valid; it’s gone across the entire nation,” said Chris Dallin, director of McKay-Dee Hospital’s public relations department. “We’re proud to be recognized for low cost health care,” the Syracuse resident said. “With our focus on high quality and low cost, I believe the efforts of our employees and staff give not only the lowest cost but among the highest quality, which says a lot about the innovation and efforts here.” The study validates earlier studies, it was noted.