Effective Approaches to Managing Newly Diagnosed Diabetes Patients

This Physician’s Weekly feature covering effective approaches to managing newly diagnosed diabetes patients was completed in cooperation with the experts at the American Diabetes Association. According to the American Diabetes Association, 23.6 million children and adults in the United States have diabetes, 25% of whom are undiagnosed. Approximately 1.6 million new cases of diabetes are diagnosed in people aged 20 and older each year. In addition, another 57 million people have pre-diabetes, a condition in which blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes. People with pre-diabetes are at an increased risk of developing diabetes and cardiovascular disease. “Identifying diabetes and pre-diabetes early is critical because the earlier clinicians take measures to help patients with lifestyle changes and appropriate medication choices the most initial success they will have and the more successful they will likely be in the long run in controlling their disease and preventing diabetes complications,” says Richard M. Bergenstal, MD. Making the Diagnosis Historically, clinicians have used tests that are based on the measurement of plasma glucose to detect diabetes in people without symptoms. These tests include a fasting plasma glucose (FPG) test or an oral glucose tolerance test (OGTT). Recently, the American Diabetes Association suggested adding the A1C test as another diagnostic tool for identifying diabetes and pre-diabetes (Figure 1). The A1C test reflects the average amount of glucose in the blood over the last 2 to 3 months, and is not affected by short-term physical and emotional stresses that can temporarily affect a blood glucose test. “A1C tests are accurate and precise, and offer several advantages...