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Trends in Diabetes Prevalence & Control

Trends in Diabetes Prevalence & Control

Analyzing trends on the prevalence of diabetes, prediabetes, and glycemic control is important for healthcare policy and planning. In an effort to update current trends, Elizabeth Selvin, PhD, MPH, and colleagues published a study in Annals of Internal Medicine that analyzed data from more than 43,000 participants. Data were collected over 20 years from the National Health and Nutrition Examination Surveys. The study team calibrated A1C levels across the 20 years of data collection and compared trends in diabetes and prediabetes defined by A1C categories with those defined by fasting glucose levels. Dramatic Increases According to findings, approximately 21 million adults in the United States (aged 20 and older) had confirmed diabetes in 2010. “The number of diabetes and prediabetes cases has nearly doubled over the last 20 years, and obesity has been a large part of the blame for these observed increases,” says Dr. Selvin. Diabetes prevalence for the entire population increased from just below 6% to about 10% over the past 2 decades. The estimated prevalence of prediabetes ranges from 12% to 30% of the U.S. population, depending on the definition used. Previous studies of diabetes prevalence have relied on single tests of glucose to identify undiagnosed diabetes. In practice, however, glucose tests should be confirmed by a second test to make the diagnosis. The study by Dr. Selvin and colleagues used a second measure—A1C—to confirm all cases of undiagnosed diabetes in order to give a more accurate estimate of the burden in the population. An important finding was that the proportion of diabetes cases that are currently undiagnosed has decreased and is now just 11% of...

Enhancing Care With Diabetes Educators

As a physician, you’re probably well aware that diabetes is an enormous problem, affecting millions of Americans, and the burden of the epidemic continues to grow each year. However, many physicians do not have the time or resources to provide the level of guidance, education, and support that patients need to manage diabetes and keep it well controlled. The good news is that diabetes educators are available to help physicians who lack the time and resources to manage these individuals. Diabetes educators are healthcare practitioners—usually registered nurses, pharmacists, or dietitians—who are intimately familiar with the disease and are skilled in providing patients with the tools and resources to help manage it. We have the expertise to coach, guide, and motivate patients, working with them to devise tailored approaches to disease management. We also are adept at reinforcing behavior changes by focusing on key self-care behaviors, such as healthy eating and being physically active. Diabetes educators can monitor patients throughout the course of their disease, thus furthering the efforts made by physicians with problem-solving strategies should diabetes-related health issues arise. Published guidelines recommend that physicians utilize diabetes educators to support efforts for educating and counseling patients and for following up with them frequently. These efforts can, in turn, improve efficiency and outcomes. We can help patients follow your orders and track their progress and provide updates in a timely manner whenever needed. Our involvement in helping patients means we can assist physicians in meeting pay-for-performance and quality improvement goals. Fortunately, diabetes education is covered by Medicare and most health insurance plans because studies show that people who receive this education...
Keeping Up With Vaccinations for People With Diabetes

Keeping Up With Vaccinations for People With Diabetes

Research has shown that patients with diabetes are more prone to getting various types of infections, which in turn can increase their risk for hospitalizations. According to Cecilia C. Low Wang, MD, FACP, it can be challenging for clinicians to ensure that their patients with diabetes are up to date with vaccinations against common infections. “Oftentimes, clinicians are busy focusing on the management of diabetes and disease-related complications,” she says. “Prevention efforts like immunizations can sometimes take a backseat to other diabetes care issues.” Influenza & Pneumonia The American Diabetes Association, the CDC, and other groups have developed recommendations to guide clinicians on the vaccinations that should be administered to patients with diabetes. Influenza and pneumococcal vaccines are recommended for all individuals with diabetes (Table 1). The flu is among the most common infections in diabetics and has been linked to high morbidity and mortality as well as an increase in hospitalizations. Published data have shown that the influenza vaccine helps reduce diabetes-related hospital admissions by nearly 80% during flu epidemics. Studies have also shown that people with diabetes appear to be at higher risk for pneumococcal infection and nosocomial bacteremia, which has a mortality rate that has been reportedly as high as 50%. “The flu and pneumonia are preventable infectious diseases,” says Dr. Low Wang. “Safe and effective vaccines are available and can greatly reduce the risk of serious complications from these infections.” The American Diabetes Association notes in its annual Standards of Medical Care in Diabetes that there is sufficient evidence to support that people with diabetes have appropriate serological and clinical responses to the influenza and...
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