DOAC are just as safe if not safer for warfarin for valvular afib (NOT valve replacement but moderate to severe mitral stenosis). Please, just give normal lovenox for covid patients. Stop DM drugs in the elderly cause no-glycemia is more dangerous than hyperglycemia. semaglutide works as along as you keep taking it. gestational diabetes screening should be a two stop process. Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation: A Population-Based Cohort Study: Annals of Internal Medicine: Vol 0, No 0 (acpjournals.org) researchers did a New-user retrospective propensity score–matched cohort study matching roughly 28,000 new users of DOACs with new users of warfarin. During a median follow-up of roughly 130 days, primary effectiveness outcome was a composite of ischemic stroke or systemic embolism. The primary safety outcome was a composite of intracranial or gastrointestinal bleeding. the rate of stroke or systemic embolism was significantly lower among DOAC users than warfarin users (3.9 vs. 6.0 events per 100 person-years). NNT of 50 The rate of major bleeding events was also lower among DOAC users (7.1 vs. 10.6 events per 100 person-years). And a NNH 28 to prescribe warfarin This would be great because no longer need an echo prior to writing for a doac—a reminder part of this exclusion was bioprosthetic or mechanical heart valve replacement Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinical Trial | Critical Care Medicine | JAMA | JAMA Network What are the effects of intermediate-dose compared with standard-dose prophylactic anticoagulation in patients with COVID-19 admitted to the intensive care unit (ICU)? Intermediate-dose (enoxaparin, 1 mg/kg daily) (n = 276) vs standard prophylactic anticoagulation (enoxaparin, 40 mg daily) (n = 286), The primary efficacy outcome was a composite of venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days, assessed in randomized patients who met the eligibility criteria and received at least 1 dose of the assigned treatment. results Among patients admitted to the ICU with COVID-19, intermediate-dose prophylactic anticoagulation, compared with standard-dose prophylactic anticoagulation, did not result in a significant difference in the primary outcome of a composite of adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days. Do the trial and don’t just blindly do it based on what you believe to be true or voodoo magic But interia takes over and we keep doing the same thing Lega IC et al. Glycemic control and use of high-risk antihyperglycemic agents among nursing home residents with diabetes in Ontario, Canada. JAMA Intern Med 2021 Mar 1; [e-pub]. We all know no glycemia is a lot worse then hyperglycemia- I also think we all know that The ADA recommends relaxed glycemic targets for older patients with diabetes and comorbidities population-based retrospective study, glycemic control among 15,000 Ontario nursing home residents with type 2 diabetes who were receiving at least one glucose-lowering drug. Mean glycosylated hemoglobin (HbA1c) level was 7.3%. On average, patients were receiving two glucose-lowering agents; about half of patients had HbA1c levels ≤7.0%. How intertia might be a good thing especially if it comes to semaglutide Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinic(continued)