Meeting the demands of diabetes (American Diabetes Assn. Scientific Sessions)

Better control would pave the way to improve health and cut costs.

By Susan J. Landers, AMNews staff. Aug. 7, 2006.

Reports from conferences important to physicians

What's the story on clinical inertia and diabetes? Are physicians really turning a blind eye when it comes to stepping up therapies for patients whose blood glucose levels and blood pressures are climbing into the stratosphere?

Some studies presented at the June 9-13 American Diabetes Assn. scientific sessions in Washington, D.C., suggested just that. But hold on, cautioned others.

Diabetes is a tough disease to manage. Given the explosion of new cases, perhaps physicians should be applauded for trying to hold the line.

That the diabetes rate is expected to rise with the nation's collective weight gain is no surprise. "The majority of American adults are overweight or obese throughout most of their lives," said K.M. Venkat Narayan, MD, chief of epidemiology and statistics in the Centers for Disease Control and Prevention's Diabetes Center. And the foreboding path from obesity to insulin resistance and then to type 2 diabetes or cardiovascular disease is well-worn.

Nearly 21 million Americans have diabetes, and the fear is that poor control of it will lead to greater numbers of severe or fatal complications such as heart disease, blindness, kidney disease and amputations.

While it's clear that physicians will need help from across the health care community and from patients themselves to achieve better management, several studies presented at the ADA meeting showed an opposite scenario in which physicians are not reaching the patients whose blood glucose levels or blood pressures are well above established goals.