Advertisement
Achieving A1C Goals: Back to the Basics

Achieving A1C Goals: Back to the Basics

Among the nearly 26 million Americans with diabetes, approximately half have not achieved an American Association of Clinical Endocrinologists (AACE)-recommended A1C goal of 6.5% or less. To address this issue, AACE and the American College of Endocrinology developed the Blood Sugar Basics: Get to Your Goals program. The program consists of an array of customizable tools and resources—available online and as hard copy materials—to encourage and empower patients with type 2 diabetes to know the importance of their A1C and work with their healthcare providers to set and achieve individualized blood sugar goals. A Helpful Resource Diabetes and its management can seem complex and overwhelming to patients, particularly for the newly diagnosed. “Patients need to understand that diabetes is a serious disease,” says Etie Moghissi, MD, FACP, FACE, the physician advisor for the Blood Sugar Basics program. “However, it’s important that they know that diabetes can be managed effectively when they’re engaged in their care.” To that end, the program—through its online home at www.bloodsugarbasics.com—provides downloadable checklists, tips for everyday management, videos, questions for patients to ask their providers, a quiz to test patients’ A1C knowledge, and more. In-depth information is provided on the importance of diet, exercise, medication (if prescribed), and monitoring and preventing symptoms. The resource also informs patients on hypoglycemia and how to avoid it. The resources fall under three overarching missions: 1. Gather intelligence. “The program provides recommendations for controlling A1C and setting specific goals so that patients can have informed discussions with their providers,” explains Dr. Moghissi. 2. Finalize a strategy. “Patients should know how to achieve their A1C goals with lifestyle changes and...
Diabetics & Ethnic Minorities: Going Beyond Black & White

Diabetics & Ethnic Minorities: Going Beyond Black & White

According to 2010 United States Census data, the number of Asians and Pacific Islanders (APIs) in the country has risen 43% since 2000. The three largest API subgroups included people of Chinese, South Asian, or Filipino ancestry. A recent report from the U.S. National Health Interview Survey aggregated API subgroups and found substantive differences in diabetes prevalence. “Unfortunately, there is still a paucity of published data on diabetes in API subgroups in the U.S.,” says Maria Rosario Araneta, PhD. “APIs have been a population group that has largely been neglected in diabetes research.” New Insights on Ethnic Differences in Diabetes In 2013, researchers in the Diabetes Study of Northern California (DISTANCE) had an analysis published in Diabetes Care that estimated racial and ethnic differences in the prevalence and incidence of the disease. The DISTANCE study involved a large, multi-ethnic cohort of patients receiving care in an integrated health delivery system. It included more than 2 million adult members of Kaiser Permanente Northern California. According to findings, there was considerable variation among the seven largest API subgroups. Pacific Islanders, South Asians, and Filipinos had the highest prevalence (18.3%, 15.9%, and 16.1%, respectively) of diabetes. These groups also had the highest incidence (19.9, 17.2, and 14.7 cases per 1,000 person-years, respectively) of diabetes among all racial and ethnic groups, including minorities who are traditionally considered high risk, such as African Americans, Latinos, and Native Americans (Figure). “Findings from this study are consistent with previous research, but there was substantial variation across the API subgroups,” adds Dr. Araneta. The Role of BMI at Diabetes Diagnosis Another key finding from the DISTANCE study...
Diabetes Side Effects: Breaking the Silence

Diabetes Side Effects: Breaking the Silence

Sexual and urologic complications among men and women with diabetes have historically received relatively little attention from clinicians. Diabetes impacts the function and structure of the lower urinary tract, including the bladder and prostate. Studies suggest that urologic complications resulting from diabetes may be even more common than that of widely recognized microvascular complications, such as retinopathy, neuropathy, or nephropathy. “Diabetes can lead to different types of sexual and urologic complications in both men and women,” says Jeanette S. Brown, MD (Table 1). “These include urinary incontinence (UI), poor bladder emptying, sexual dysfunction, lower urinary tract symptoms (LUTS), and urinary tract infections (UTIs). Treatment options are available for many of these sexual and urologic complications. Unfortunately, these problems often go unaddressed because patients oftentimes will not discuss these issues with their clinicians.” Caring for Women: Lower Urinary Tract Symptoms Urinary incontinence has been estimated to be more common in women with type 2 diabetes than in women with normal glucose levels (Table 2). There is also evidence that women with pre-diabetes are at higher risk for incontinence. The clinical diagnosis of UI—and more broadly, LUTS—is typically based on a variety of factors, and Dr. Brown says that clinicians can be proactive by paying attention to patient complaints when they arise. “It can often be difficult for women to speak up when they develop issues like UI, LUTS, or UTIs, but we should be asking them about these symptoms regularly during office visits,” Dr. Brown says. “When symptoms are identified, we can then take that opportunity to educate patients about the possible treatment options that are available to manage these...
New Guidelines for Managing Hyperglycemia in Type 2 Diabetes

New Guidelines for Managing Hyperglycemia in Type 2 Diabetes

In recent years, more pharmacologic agents and treatment options have become available to treat hyperglycemia in type 2 diabetes. With the influx of new therapies, it can sometimes be challenging for clinicians to integrate these new therapies into treatment regimens. New guidelines and position statements from well-respected organizations can assist clinicians, but these documents evolve over time based on new information. Download free patient education brochures from the Patient Education Center, developed by Harvard Medical School. Insulin Therapy Click here to download Diabetes: Goals for Good Health Click here to download Several years ago, the American Diabetes Association and the European Association for the Study of Diabetes convened a group that developed consensus recommendations for antihyperglycemic therapy in non-pregnant adults with type 2 diabetes. Since that time, more information on the benefits and risks of glycemic control has emerged. In addition, there is new evidence on the efficacy and safety of several new drug classes as well as the withdrawal and the restriction of others. Furthermore, experts are suggesting that greater attention be paid to moving toward approaches to care that are more individualized and patient-centered. New guidelines on the management of hyperglycemia have been published concurrently in the April 19, 2012 online editions of Diabetes Care and Diabetologia. “Guidelines are constantly in a state of evolution based on new information,” says Vivian A. Fonseca, MD. “This document reflects recent data and availability on multiple treatment options for a variety of patients. In addition, the American Diabetes Association updates its overall standards of care every January. These new guidelines take a more holistic approach, focusing on treating people as...

2012 ADA Annual Scientific Sessions

New research was presented at the American Diabetes Association’s 72nd Scientific Sessions from June 8-12, 2012 in Philadelphia. The features below highlight just some of the studies that emerged from the conference Heart & Cancer Risks With Insulin The Particulars: Previous research suggests that there may be an association between insulin use and an increased risk of myocardial infarction, stroke, and several types of cancer. However, the long-term impacts of insulin on serious cardiovascular outcomes and cancers in patients at high risk for type 2 diabetes have not been examined. Data Breakdown: A study randomized people at high risk for type 2 diabetes or in the early stages of it to daily insulin glargine injections or no insulin for an average of 6.2 years. No differences in cardiovascular outcomes or the development of any cancer type were observed in the two groups. Patients who received insulin maintained normal glucose levels (90 to 94 mg/dL) throughout the study. Take Home Pearl: Long-term use of insulin glargine in patients at high risk for type 2 diabetes or in the early stages of the disease does not appear to put them at greater risk of developing cardiovascular conditions or cancer. Type 1 & 2 Diabetes Prevalence Increasing in the Young The Particulars: For years, the prevalence of type 1 and type 2 diabetes has been increasing in younger people worldwide. Few data, however, have explored trends in both type 1 and type 2 disease in the United States among younger individuals. Data Breakdown: An analysis from the CDC and NIH found that the prevalence of type 2 diabetes increased 21%, and the...
Page 1 of 3123
[ HIDE/SHOW ]