.
Introduction Continuous glucose monitors (CGMs) are increasingly central to diabetes care. In pharmacy and graduate medical education, CGM wear experiences improve empathy and counseling confidence; evidence in undergraduate medical education is lacking. Objective This study evaluated the impact of a CGM wear experience for second-year medical students during orientation for a longitudinal primary care clerkship. Methods The orientation, facilitated by clinical pharmacists, included a didactic lecture and skills laboratory on insulin dosing, administration, and CGM fundamentals. Students applied a CGM sensor to wear for up to 10 days. Pre- and post-intervention surveys assessed demographics, CGM-related confidence, empathy toward people with CGMs, and practice-changing intent. Surveys were administered one week before and 12 days after the lab and results were analyzed using student t-tests. Results Of 50 enrolled students, 37 completed the pre-survey and 19 completed the post-survey. Baseline demographics demonstrated limited prior CGM experience (13.5%). Empathy scores were high at baseline, with higher ratings for expected healthcare professional empathy compared to self-reported empathy (6.25 vs. 4.10, p<0.001). Overall empathy significantly increased following the intervention (+1.25, p<0.001). Confidence across CGM competencies significantly improved, with an overall increase of 3.07 points (p<0.001), particularly in CGM application, data interpretation, and counseling on access. Post-survey responses demonstrated strong practice-changing intent, including plans to incorporate CGMs into future practice and improved understanding of CGM-informed decision-making (mean scores > 6.3/7). Conclusion A CGM wear experience for undergraduate medical students improved empathy for patients wearing CGMs, increased confidence in CGM-use and counseling, and led to a high number of participants planning to incorporate CGMs into their practice. Findings will inform strategies for early integration of wearable diabetes technology into medical curricula.
Introduction and Purpose: Dysmenorrhea, particularly primary dysmenorrhea, is a common gynecological condition characterized by cyclical and often severe pain, typically managed with analgesics such as NSAIDs, acetaminophen, and opioids. Habitual, suboptimal, or excessive use of these medications may facilitate the transformation of episodic headaches into chronic forms through central sensitization and receptor-level changes in the central nervous system. Despite widespread pharmacotherapy, comprehensive synthesis regarding its role in chronic migraine development is lacking. This review systematically summarizes data from cohort, case-control, and interventional studies to evaluate the relationship between dysmenorrhea pharmacotherapy and chronic migraine risk. The study examines whether medication type, frequency of use, and patient-related factors—including age at dysmenorrhea onset, pain severity, comorbid psychiatric disorders, and use of migraine prophylactic agents—modulate this risk. Results: Medication overuse headache (MOH) arises from excessive use of acute headache medications in patients with primary headache disorders, most commonly migraine. Opioids, butalbital-containing analgesics, acetaminophen–aspirin–caffeine combinations, and triptans confer the highest risk of chronification, while NSAIDs carry moderate risk and hormonal therapies may reduce pain frequency and intensity, potentially decreasing the need for frequent analgesic use. Frequent acute medication use (NSAIDs or acetaminophen ≥15 days/month, opioids/triptans ≥10 days/month), early dysmenorrhea onset, severe pain, and comorbid psychiatric conditions significantly increase MOH and chronic migraine risk. Implementation of prophylactic therapies and patient education can reduce reliance on acute medications and mitigate headache chronification. Conclusion: Analgesic use in dysmenorrhea carries a risk of chronic migraine development, particularly with high-frequency or high-risk medications. Hormonal therapies, prophylactic strategies, individualized treatment, and monitoring of acute medication use are critical to minimize MOH and optimize long-term outcomes.
The dose-response relationship between physical activity characteristics, cardiopulmonary fitness and mortality are well-established, but the relationship between running characteristics and long-term outcomes in recreational athletes remains largely unknown. We investigated associations between absolute and relative running speed (km/h and % of winner`s speed) with all-cause mortality in recreational athletes. We extracted data (e.g. sex, age, running speed, individual and winners running time) from the organisers of the Seven Hills Run, a 15 km road race in a city, the Netherlands, between 1995 and 2016. All-cause mortality status was retrieved from the Dutch Population Registry up to January 2018. Absolute (km/h) and relative running speed (running speed/winners speed x 100%) was calculated separately for each sex and year of the running event. The associations between absolute running speed (slowest speed category as reference) and relative running speed (highest percentage category as reference) with all-cause mortality were analysed using Cox proportional hazard models adjusted for sex and age, and separately in sex stratified analysis. Data from 141,507 participants were included. Participants were more often males (71.91 %), with a median [first, third quartile] age of 39 [31 - 46] years old and running speed of 11.27 [10.29 - 12.40] km/h, equalling 182±30 % of winner`s time (mean ± SD, winners speed: 20.0±0.35 km/h). During 10 [5 – 14] years of follow-up, a total of 1585 deaths occurred (1.12%), with a death rate of 1.1 deaths/1,000 participant-years of follow-up. All running speeds categories except the 10.1-10.5 km/h and 12.6-13.5 km/h categories were associated with a reduced risk of all-cause mortality (HR [95 % CI]; 10.6-11.0 km/h: 0.74 (0.60-0.93), 11.1-11.5 km/h: 0.69 (0.55-0.86), 11.6-12.0 km/h: 0.71 (0.56-0.89), 12.1-12.5 km/h: 0.78 [0.62-0.98], >13.5 km/h: 0.75 (0.59-0.95)) compared with the slowest running category (<9.5 km/h, Figure 1A). Sex-specific analyses revealed that the association between absolute running speed and all-cause mortality was present in males but not in females (Figure 1B). Only two relative running speed categories (177 %-185 % and 193 %-200% of the winner`s time) were associated with significant risk reductions for all-cause mortality compared to the slowest category (>215 % of the winner`s time) (Figure 1C). Similar associations between relative running speed and all-cause mortality as observed in the sample analysis were also observed in male but not female runners (Figure 1D). Faster male runners live longer than slow runners (<9.5 km/h), but the fastest runners (>13.5 km/h) did not outperform the runners with a moderate-to-high speed (10.6-12.5 km/h). In contrast, faster female runners had similar mortality risks as slow female runners.
