Migraine Doctors in Short Supply Across U.S.

Only 416 specialists available nationwide, study found

By Robert Preidt

HealthDay Reporter

FRIDAY, June 28 (HealthDay News) -- There are too few migraine headache specialists in the United States, a new study finds.

Migraines affect about 36 million Americans over age 12 (more than 11 percent of the population). That's more than the number affected by asthma and diabetes combined. However, only 416 specialists nationwide are certified by the United Council for Neurologic Subspecialties to diagnose and treat migraine, according to researchers.

States with the highest number of migraine specialists include New York (56), California and Ohio (29 each), Texas (25), Florida (24) and Pennsylvania (23). Six states have no migraine specialists, according to the study presented this week at the International Headache Congress meeting in Boston.

States with the worst specialist-to-patient ratios include Oregon, Mississippi, Arkansas and Kansas. The District of Columbia has the best ratio, followed by New Hampshire, New York and Nebraska.

"This is a troubling picture," study leader Dr. Noah Rosen, of the Pain and Headache Center of the North Shore-Long Island Jewish Health System, said in a congress news release. "Migraine is a highly disabling disorder -- the seventh most disabling in the world and the fourth most disabling among women. It's clear that many more specialists need to be trained and certified to meet the need."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Migraine costs the United States more than $29 billion a year in direct medical expenses such as doctor visits and medications, and indirect expenses such as missed work and lost productivity, the release noted.

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Countries With More Sugar in Food Supply Have More Diabetes

By Serena Gordon

HealthDay Reporter

WEDNESDAY, Feb. 27 (HealthDay News) -- It's a common belief that type 2 diabetes is caused by eating too much sugar. While it's not nearly that simple, a new study bolsters the connection between the disorder and sugar consumption.

The study found that even when researchers factored obesity out, an association still remained between the amount of sugar in the food supply and a country's rate of diabetes.

"The old mantra that 'a calorie is a calorie' is probably naive," said study lead author Dr. Sanjay Basu, an assistant professor of medicine at Stanford University. "Some calories may be more metabolically harmful than others, and sugar calories appear to have remarkably potent properties that make us concerned about their long-term metabolic effects. This study also suggests that obesity alone may not be the only issue in [the development of] diabetes."

Results of the study are published Feb. 27 in the journal PLoS One.

The prevalence of diabetes in the world has more than doubled over the last 30 years, according to study background information. That means nearly one in 10 adults in the world has diabetes, and most of those have type 2 diabetes. (The less-common type 1 diabetes is an autoimmune disease that's not related to food intake.)

Although the development of type 2 diabetes is associated with obesity and sedentary lifestyles, not everyone with type 2 diabetes is overweight, according to the American Diabetes Association. A genetic susceptibility to the disease is also believed to play a role.

Previous research has suggested that obesity isn't the only driver in the development of type 2 disease, and some studies have pinpointed excessive sugar intake, particularly sugars added to processed foods.

To get an idea of whether sugar plays an independent role in type 2 diabetes, Basu and his colleagues reviewed data from the United Nations Food and Agricultural Organization on the availability of foods in 175 countries. They also obtained data on the prevalence of diabetes in adults from the International Diabetes Federation.

Using statistical methods to tease out certain factors, such as obesity, the researchers found that the availability of sugar in the diet was linked to diabetes. For every additional 150 calories of sugar -- about the amount in a 12-ounce can of sweetened soda -- that were available per person daily, the prevalence of diabetes rose 1 percent in the population.

And, this rise was independent of obesity, physical activity and other factors that might contribute to the development of type 2 diabetes, the investigators found.

But, when the researchers looked at 150 additional calories per person a day from other sources, they found only a 0.1 percent rise in the rate of diabetes.

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Kids' Tamiflu Still in Short Supply

Feb. 21, 2013 -- With flu season dragging on, supplies of the children’s version of the flu drug Tamiflu continue to dwindle nationwide, according to the drug's maker.

The liquid medicine, called Tamiflu OS (for oral suspension), is approved for children 2 weeks old and older.

It attacks the flu virus, helping to lessen the flu's ability to spread in the body. It must be taken within 48 hours of the first symptoms. In clinical trials, it did not cure the flu, but shortened its length by 1.5 days in kids.

Supplies are spotty. "While we have shipped all quantities of Tamiflu OS to distributors, some retail pharmacies may still have it," says Tara Iannuccillo, spokeswoman for Genentech, the drug's maker.

"However, quantities are limited nationwide," she says.

No additional supplies of Tamiflu OS will be available for this season, Iannuccillo says.

"Given the amount of time it takes to manufacture Tamiflu OS, we don't plan to make more for the 2012/13 flu season, as it wouldn't be ready in time," she says.

However, the adult version is still available. Parents can ask their pharmacist to make a liquid suspension for children using the adult Tamiflu capsules, Iannuccillo says.

Concerns about a Tamiflu shortage began earlier in the season. In mid-January, the FDA warned of upcoming occasional shortages of the children's medicine.

Supplies of Tamiflu for children ran low due the severity of this year's flu season, Iannuccillo says. Compared to past seasons, flu season began earlier this year, according to the CDC.

To ensure continued supplies of the adult version, the FDA is allowing Genentech to distribute 2 million units of the 75-milligram capsules that have an older version of the package insert, says Sarah Clark-Lynn, an FDA spokeswoman.

"These additional reserve supplies of Tamiflu 75-milligram capsules are not outdated," she says. "Only some information included in the labeling is older."

The older labeling does not have dosing information for children aged 2 weeks to less than 1 year, for instance.

The FDA just granted the approval of Tamiflu OS for younger children in December.

Both children's and adults' Tamiflu is $101.50 a package, Iannuccillo says. On average, the co-pay for insured people is $35, she says.

"The vast majority of insurance plans cover Tamiflu, including Medicare and Medicaid," she says. The company also offers a $10 co-pay coupon on its web site, she says.

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