Laxity in Diabetic Care in the US
Less than 12% of people with diabetes in the US meet the recommended goals
for blood glucose, blood
pressure, and cholesterol despite much research showing
that controlling these conditions dramatically delays or prevents the
complications of diabetes. Moreover, the percentage of people who achieve these
targets has changed little in the last decade.
Quote: "If you're a diabetic
over 55, you should be on an aspirin a day, a lipid-lowering agent [to lower
cholesterol], and a medication to prevent heart attacks, like an ACE inhibitor. Heart attacks kill 80% of
diabetics, and you can drop that by 70% by taking those three medications. You
should therefore see your provider and discuss getting on them. Simple three
pills, very safe and very simple, with almost no side effects. It could add
years to your life." (Dr. R. James Dudi, Kaiser Permanente Health Plan, San
Diego)
Barbara K. Hecht,
Ph.D.
Frederick Hecht, M.D.
Medical Editors, MedicineNet.com
Diabetes Related Information:
Heart Related Information:
Most People with Diabetes Do Not Meet Treatment Goals
Study finds little improvement in last decade
Less than 12 percent of people with diagnosed diabetes
meet the recommended goals for blood glucose, blood pressure, and cholesterol
despite a great deal of research showing that controlling these conditions
dramatically delays or prevents diabetes complications. Moreover, the percentage
of people who achieve these targets has changed little in the last decade,
according to a study published in the January 21, 2004, issue of the Journal of
the American Medical Association.
"More diabetes patients are taking medication to control
their blood
pressure and cholesterol, but too few are making needed lifestyle changes such
as exercising, lowering dietary fat, and losing
weight to control the risk factors for diabetes complications," noted author Dr.
Catherine Cowie of the National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK), one of
the National Institutes of Health.
The researchers compared data obtained from a nationally
representative sample of U.S. adults age 20 years and older with diagnosed
diabetes who took part in either the Third National Health and Nutrition
Examination Survey (NHANES
III) conducted from 1988 to 1994 or the NHANES conducted from 1999 to 2000.
Participants in the later survey, though similar in age
and gender, were heavier, diagnosed with diabetes younger, and more likely to be
using insulin along with oral drugs to treat their diabetes. Only 37 percent
(compared to 44 percent in the earlier NHANES) were achieving the American
Diabetes Association's (ADA) goal for blood glucose control--a hemoglobin A1c (HbA1c) blood test result
of less than 7 percent. About 37 percent of participants in the later survey had
HbA1c levels above 8 percent, ADA's recommended "take action" level.
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