For diabetes patients, keeping blood sugar levels under good control for many years can reduce the risk of suffering a heart attack, stroke, heart failure or amputation by about 17%, according to a new study published in the June 4 issue of the New England Journal of Medicine.

Patients may not have to keep their blood sugar levels super-low to reap most of the cardiovascular benefit. The authors concluded that a long-term average of about eight on the measurement called A1C hemoglobin was enough to achieve most of the benefit, but that many patients can be safely lowered to around 7

The study was conducted by a team from three VA hospitals, the VA Center for Clinical Management Research and the University of Michigan Medical School. They show what happened to nearly 1,800 veterans with Type 2 diabetes nearly 10 years after they signed up for a six year blood sugar study that randomly assigned them to either get help achieving “tight” blood sugar control, or regular care.

Read also:

Early detection and treatment of type 2 diabetes may reduce heart disease and mortality

 “Taken together with findings from other large studies, we see that controlling blood sugar in diabetes can indeed decrease cardiovascular risk, though we continue to see no effect on risk of dying during the same time period,” said lead study author Rodney Hayward, MD, of the VA Ann Arbor Healthcare System and U-M. “This finding reinforces the importance of combining good blood sugar control with control of other cardiovascular risk factors for a combined effect.”

Hayward notes that for anyone with Type 2 diabetes, a growing body of research supports the idea of taking four medications to help their hearts: metformin to control blood sugar, a statin to control cholesterol and other blood lipids, a blood pressure medication, and aspirin.

This quartet of drugs, combined with diet, stopping smoking and exercise, could help millions of people stave off the heart attacks, strokes, heart failure and amputations due to poor circulation that cause so much premature death and disability among people with diabetes. They may also help prevent the other issues that can arise from the effect of diabetes on small blood vessels, including blindness, nerve pain or numbness, and kidney failure.

But striving for even lower A1C levels in all people with diabetes may not increase cardiovascular benefit enough to be worth the effort, Hayward notes —especially if patients receive newer drugs with unclear long-term safety, already take many other medications, or experience medication-related issues such as weight gain or frequent low blood sugar reactions.

“Once someone has his or her A1C around 8%, we need to individualize treatment to the patient, balancing his or her individual cardiovascular risk based on personal and family history, his or her age and life expectancy, smoking history and medication side effects,” he says. “If you want to determine what the best A1C number is for you, and when should take another medication to lower it, you should decide with your doctor.”

More about the study
The data for the new analysis came from 1,791 veterans who enrolled in the Veterans Affairs Diabetes Trial or VADT. For the new paper, the researchers dug through VA and Medicare records to find out how the veterans were doing more than five years after the study, called ended.

The finding of a statistically significant reduction in cardiovascular events -- heart attack, stroke, new diagnosis of heart failure or gangrene-related amputation—among the intensive control group is similar to what has been seen in other studies. Interestingly, the original VADT study did not find a significant cardiovascular benefit from tight glucose control after only five to six years of follow-up, and this finding only emerged after longer follow-up.

But the size of the benefit from good blood sugar control was smaller than what other studies have shown about the impact of keeping blood pressure and cholesterol under control in diabetes. That’s why it’s important to look at an individual’s underlying cardiovascular risk and why blood pressure medications and statins are particularly important for preventing heart attacks and strokes in people with diabetes.

The researchers note that their results should not be used to justify an across-the-board A1C target of seven for all people with diabetes. Rather, they say, any quality measure for doctors and hospitals that use A1C as a measure of blood sugar control should also take into account a patient’s risk of cardiac events, of low blood sugar reactions, and what additional medications would be needed to lower A1C further.

In addition to Hayward, the study’s authors are Peter D. Reaven, MD, Wyndy L. Wiitala, PhD, Gideon D. Bahn, PhD, Domenic J. Reda, PhD, Ling Ge, MS, Madeline McCarren, PhD, William C. Duckworth, MD, and Nicholas V. Emanuele, MD.

...

(HealthDay News) -- Statin use may lower mortality in the weeks and months after coronary artery bypass graft surgery, according to a study presented at the annual meeting of the European Society of Anaesthesiology.

The new study was based on data involving more than 16,000 British patients. All were at least 40 years old at the time they underwent coronary artery bypass graft surgery, and the researchers tracked outcomes at 1 month and 6 months after the surgery. 

Apart from statins, many of the patients had been taking a broad range of other types of cardiovascular medications prior to the surgery. For example, nearly three-quarters were taking ?-blockers, more than 60% were taking angiotensin converting enzyme inhibitors, and nearly 45% were taking calcium channel blockers.

However, after conducting 5 statistical analyses, the team found that only the use of statins was tied with a significant protective effect in reducing a patient's postoperative mortality risk. This finding remained even after the researchers factored in each patient's prior history of other chronic illnesses. Simvastatin was tied to the most significant drop in postoperative mortality risk (a 77% decline).

The study was led by Robert Sanders, Ph.D., an assistant professor of anesthesiology at the University of Wisconsin in Madison. His team of U.S. and U.K. researchers noted that the vast majority of patients included in the analysis -- roughly 85% -- were already routinely taking a statin before their heart surgery. "The unknown is why the other 15% were not on statins," Sanders told HealthDay. Some may have had an intolerance to the medications or adverse effects, while others might simply not have been offered the cholesterol drug by their physicians, he noted.

...

Robert Margolis Insider Sell Transaction

Considering the transaction Robert Margolis made he is in the insider trades focus today. The Co-Chairman of the Board of DaVita HealthCare Partners Inc (NYSE:DVA) 81.92 -0.62 -0.75% and an insider, unloaded 31,400 shares worth $2,618,461 U.S Dollars. The average price was $83.4 per share. In the last month, he also unloaded 31,400 shares worth about $2,597,829 USD. The date of trade was June 5, 2015, and it was revealed in a SEC-filed Form 4, which you can locate here. The probability of this sell staying unseen is super low as it’s significant, with Robert Margolis now having rights to 2.45 million shares – that is 1.14% of the company’s total market cap.

Davita Healthcare Partners Inc Stock Rating, Sentiment and Fundamentals

Because the insider transaction is symbolic, it might mean that Robert is a pessimist regarding Davita Healthcare Partners Inc’s stock worth. According to the fifteen analysts that are covering this company’s financial reports, there is an expectation of earnings for every share of $3.77 for the 2015 year, which gives Davita Healthcare Partners Inc a Price to Earnings ratio of 21.89. Furthermore, an earnings-per-share growth rate year-on-year of 12.50% is expected. Apparently he is not the only one. The stock market seems to agree given the Bulls / Bears Sentiment Index is 0.92 according to Psychsignal.

* Read How Our Stock Ratings System Works

Our analysts place NEUTRAL rating on the stock based on our trend-following model which is depicted below. Davita Healthcare Partners Inc’s share price is still trending upward from the last 200 days, during which it has risen by 11.84%.

Price Chart of Davita Healthcare Partners NYSE:DVA Stock

Source: RightEdgeSystems, Yahoo Split & Dividend Adjusted Data and OctaFinance Interpretations

Well-known stock market traders such as Ray Dalio have often claimed that the best returns are made through fundamental and technical analysis. This is definitely not the case with this company.

Hedge Funds Ownership

SEC filings showed that, 468 institutional players had shares of Davita Healthcare Partners Inc. Octafinance tracked institutional and hedge funds have traditionally had a very high interest in Davita Healthcare Partners Inc’s stock, and that was also the case in the last quarter. The institutional ownership was 197.83% of the stock’s outstanding shares. They increased by 249.27 million the total shares they hold. As of that quarter these institutional and hedge funds owned 425.33 million shares. A total of 31 funds closed their positions in Davita Healthcare Partners Inc and 156 reduced their holdings. There were 56 funds that created new positions and 187 funds that added to their positions.

This company is Top 10 in 16 of them. These are: Foundation Asset Management Lp, Swift Run Capital Management Llc, Summit Partners L P, Timessquare Capital Management Llc, Cognios Capital Llc, Triple Frond Partners Llc, Hikari Power Ltd, Gates Capital Management Inc., Hikari Tsushin Inc., Roundview Capital Llc.

Bluestein R H & Co had the greatest investment with ownership of 10,650 shares as of Q4 2014 for 0.05% of the fund’s portfolio. Dock Street Asset Management Inc is another bullish asset manager having 57,383 shares of the company or 2.29% of their stocks portfolio. The stock is also 1.06% of the fund’s AUM. In addition First Republic Investment Management Inc. have 0.01% of their stock portfolio invested in the company’s market cap for 7,274 shares. The Massachusetts-based fund Foster Dykema Cabot & Co Inc Ma revealed it had acquired a stake worth 2.05% of the fund’s stock portfolio in Davita Healthcare Partners Inc. The Illinois-based fund Geneva Advisors Llc is also positive about the Colorado-based company, owning 5,435 shares or 0.01% of their stock portfolio.

DaVita HealthCare Partners NYSE:DVA Company Profile

DaVita HealthCare Partners Inc. consists of two divisions, Kidney Care and HealthCare Partners (HCP). Kidney Care is a provider of dialysis services in the United States, treating patients with chronic kidney failure and end stage renal disease (ESRD). Kidney Care division develops innovative clinical care, offers integrated treatment plans, personalized care teams and health-management services. As of December 31, 2014, we provided dialysis and administrative services in the U.S. through a network of 2,179 outpatient dialysis centers in 46 states and the District of Columbia, serving a total of approximately 173,000 patients. HealthCare Partners division is a patient- and physician-focused integrated health care delivery and management company. HealthCare Partners manages and operates medical groups and affiliated physician networks in Arizona, California, Nevada, Florida and New Mexico. As of December 2014, HealthCare Partners had approximately 837,000 members under its care.

Company Website: DaVita HealthCare Partners

Today its market cap is: $17.75 billion and it has 214.89 million shares outstanding. The company has 57900 employees. Today the company has 86.62% shareholders and the institutional ownership stands at 86.62%. Davita Healthcare Partners Inc was formed in Delaware on 1994-04-04. The stock closed at $82.54 yesterday and it had average 2 days volume of 246995 shares. It is up from the 30 days average shares volume of 243342. Davita Healthcare Partners Inc has a 52w low of $69.83 and a 52 weeks high of $85.17. The current price is above the 200 days SMA. Davita Healthcare Partners Inc last issued its quarterly earnings report on 05/04/2015. The company reported 0.86 EPS for the quarter, above the consensus estimate of 0.85 by 0.01. The company had a revenue of 3.29 billion for 3/31/2015 and 3.33 billion for 12/31/2014. Therefore, the revenue was -40,052,000 down.

* The sales reported on this Form 4 were made pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on September 18 – 2014.

* Represents the weighted average sale price of $83.7702. The range of prices for the sale of these shares was $83.59 – $83.94 – rounded to the nearest hundredths. The reporting person undertakes to provide upon request by the Commission staff – the Issuer – or a security holder of the Issuer – information regarding the number of shares purchased or sold at each separate price.

* Represents the weighted average sale price of $82.8881. The range of prices for the sale of these shares was $82.46 – $83.45 – rounded to the nearest hundredths. The reporting person undertakes to provide upon request by the Commission staff – the Issuer – or a security holder of the Issuer – information regarding the number of shares purchased or sold at each separate price.

* The shares were sold by Robert and Lisa Margolis Family Trust – 7/27/2000.

* Represents the weighted average sale price of $83.5757. The range of prices for the sale of these shares was $83.46 – $83.79 – rounded to the nearest hundredths. The reporting person undertakes to provide upon request by the Commission staff – the Issuer – or a security holder of the Issuer – information regarding the number of shares purchased or sold at each separate price.

* The shares are held by Margolis Family GST Exempt Trust – 12/11/2012.

Tagged: DaVita HealthCare Partners - (NYSE:DVA)Robert Margolis

...

...