Challenge of diabetes management continues

Doctors and patients are urged to follow more rigorously guidelines to reduce the high level of complications that result when the disease is not controlled.

By Susan J. Landers, AMNews staff. Aug. 5, 2002.

Washington -- Managing the care of diabetic patients most often falls to their primary care physicians. It's not an easy job, but control of blood sugar levels is crucial if patients are to avoid the host of serious complications that can befall them.

"Every year up to 25,000 Americans go blind, and the largest single reason is diabetes," said Alan Garber, MD, PhD, a professor of medicine at Baylor College of Medicine, Houston, and chief of endocrinology, diabetes and metabolism at Methodist Hospital, Houston.

An equally large number of diabetics develop kidney disease requiring dialysis, and the threat of cardiovascular disease is also considered high.

The fact that so many patients suffer these serious consequences indicates to Dr. Garber and others that they are not maintaining optimal blood glucose levels. "In general, these complications of diabetes are completely preventable," he said.

New federal campaigns are underway to promote exercise and improvements in diet -- steps that should rein in the recent increase in the numbers of Americans with diabetes. And research dollars will continue to be spent in attempts to provide those with the disease with more user-friendly tools to control it. But for the here and now, patients with diabetes are failing to take advantage of available medications and techniques to prevent the consequences of not controlling the disease.

Dr. Garber spends a great deal of time writing guidelines for both specialists and primary care physicians on the treatment of patients with diabetes. "But we have a situation where the overwhelming majority of our patients are not achieving the old goals let alone the newer, lower goals." [...]