Image provided by: University of Oregon Libraries; Eugene, OR
About Just out. (Portland, OR) 1983-2013 | View Entire Issue (July 3, 1997)
12 ▼ ju ly 3 . 1 9 9 7 ▼ j u s t o u t DITCH TECH ACRES national news dnaay a>\sjm®dl aamdl cDipcsrpaitlcsdlS • Native plants • Fruit, nut, shade and flowering trees • perennials and shrubs • ORGANIC CONTROLS!! LANDSCAPE DESIGN and MAINTENANCE AVAILABLE!! No tax to Oregon buyers!! From Interstate 5. take Exit #16 to La Center, cross the bridge, turn right on 4th St., left on Highland Ave. 2 9 mi. through S curves to 369th St., left on NE 369th St. and then left i . e o 1 c n c on NE 31st Ave. ^ 2 6 3 -1 5 0 5 , Hours: Fri. Sat. 9-6, Sun11-5 A BENEFIT MUSK, ft DANCING PINK M A K h N l - VAlGAROfcHA • 36009 NE 31st Ave, La Center, WA Some people have not begun protease inhibi tor therapy because they do not have health insur ance. Others, meanwhile, have stopped taking medications in order to get sick and poor enough to qualify for Medicaid. Proposed changes to Medicaid now before Earlier in the year, Vice President A1 Gore Congress could strip away consumer protections spoke of expanding Medicaid drug coverage to for millions and threaten their health care. Seven include people with HIV who do not meet an member organizations of the Consumer Coalition AIDS definition. The idea was to have states for Quality Health Care made those remarks at a request waivers in order to expand their Medicaid June 16 news conference in Washington, D.C. coverage. Various committees of both the House and According to Lubinski, July 1 marked the Senate are considering a multitude of proposals as original target date "to have those solicitations on part of the budget bill. the street.” That timeline, however, will not be The situation is so volatile that consumer met. Yet while Lubinski says she’s concerned advocates fear that disenrollment options, appeal that the process is moving processes and external re views may be lost in the rapid “Congress is opening a so slowly, she is even more troubled by some of the shuffle of Medicaid recipi Pandora’s box that may possible guidelines being ents into managed care, considered. “They need to coupled with the devolution exacerbate access to make it not so burdensome of authority from the federal care [a] crisis already that states won’t even try to the state levels. [to get the waiver],” she “Congress is opening a faced by thousands of says. Pandora’s box that may ex There has been talk of acerbate access to care— [a] people with AIDS, says limiting the number of crisis already faced by thou Christine Lubinski, deputy states or the total number sands of people with AIDS,” of patients nationally al says Christine Lubinski, director of the AIDS lowed on a waiver. deputy director of the AIDS “So you’ve got the situ Action Council. Action Council. ation where California and (The government esti mates that half of all people living with AIDS will New York might say, T o hell with it, I’m not applying with a 30,000-threshold because that end up on Medicaid at some point.) might not even cover all of my people,’ ” she says. Lubinski says that people with special health Moves in Congress and at the Centers for problems require expertise often lacking in many Disease Control to increase surveillance from an managed care operations. AIDS definition to HIV infection could put even Under current law, the Health Care Finance more pressure on the limited existing resources. Administration must review and issue a waiver to “If they are going to argue that AIDS as a states wishing to move Medicaid recipients into surveillance measure is outmoded, which it may managed care programs. well be, then they damn well better start saying The process has allowed consumers to partici that AIDS as a measurement of disability, or as a pate in shaping the requirements of such pro measurement of access to health care, is equally grams, but that may be stripped away. outmoded,” says Lubinski. A Catch-22 of Medicaid for most people who are living with HIV is that they must be poor and sick enough in order to qualify. Reported by Bob Roehr Medicaid proposals bode ill for people with HIV/AIDS Vltt H A IL A L U N HARRISON ft PR ItN O S • S W M G L IN * C U B S ft M O R f .! av. LOUISIANA PACIFIC NIKE PÛRTIAN0 TRAJLBIATERS spo n so red 8AM< Of AMERICA EPITOPE FOX « Investing takes more than money... it takes vision, service, performance. — ” Fred Elledge, Financial Consultant 121 SW Morrison Street, Suite 1600 Portland, OR 97204 ( 503 ) 248-2279 or ( 800 ) 452-0966 S mith B arney They make money the old-fashioned way. They earn it.* A Member of TravelersGroupT Protease inhibitors may increase diabetes risk Protease inhibitors may contribute to the onset or worsening of hyperglycemia and diabetes among some people who take the drugs—that according to a June 11 advisory from the federal Food and Drug Administration to health care professionals. The information is tentative, the numbers are small, and no causal link has been proven. How ever, the FDA is concerned enough to advise monitoring people on protease inhibitors for symp toms. The agency will gather information in order to determine the scope of the problem and will require that labeling for protease inhibitors be modified to carry a warning of this potential side effect. Eighty-three patients developed hyper glycemia or diabetes while on protease inhibitors, 27 required hospitalization. The reaction was observed with all four of the approved drugs. The incidents have occurred in significantly less than 1 percent of the estimated 150,000 people who take one or more of the protease inhibitors. Low-grade symptoms include increased hun ger, unexplained weight loss, increased urination, fatigue, dry and itching skin. The acute phase of ketoacidosis is characterized by “a fruity mouth odor, nausea, dehydration, weight loss, confusion and, if untreated, death.” Onset was as rapid as four days in one instance, though the average was 76 days. The FDA letter emphasized, “At the present time there exists no conclusive evidence estab lishing a definite causal relationship between protease inhibitor therapy and the incidence of diabetes and hyperglycemia.” The patients were on other drugs for HIV, and some used medications to prevent opportunistic infections or for other medical problems. Some of those other drugs “have been associ ated with the development of diabetes.” The FDA is advising doctors and patients to monitor blood-sugar levels—something which should already happen with quarterly blood workups—and modify diet, or initiate or modify treatment as appropriate to control diabetes. The FDA is not advising halting the use of protease inhibitors. As the agency’s AIDS chief, David Fiegal, puts it, “HIV is harder to treat than diabetes.” Spencer Cox of the Treatment Action Group in New York says there is “no cause for alarm.” However, he strongly urges consumers and doc tors to integrate this information into the monitor ing of their own or their patients’ health. Cox also wants doctors to take the time to report these developments, so that a clearer pic ture of the problem will develop. He acknowledged that early symptoms of dia betes may be difficult to separate out from other symptoms associated with HIV and its treatment. The data released by the FDA were limited and did not indicate whether these effects were seen over the entire spectrum of HIV disease. Ben Chang of Project Inform in San Francisco wonders if the effects are more likely to occur in people with advanced disease “where their body metabolism may be different.” He also views the news with curiosity rather than alarm. “It was only 83 people out of all of those on protease, the incidence is really very small,” he says. Reported by Bob Roehr