Friday, May 17, 2013
I believe , the key to success in a persons diabetes care is ____?____ .
I will review some of the abstracts from the recent American Association of Clinical Endocrinologists annual meeting over the next week.
BARRIERS TO INSULIN INITIATION IN TYPE 2
DIABETES MELLITUS - A SINGLE INSTITUTION
STUDY AMONG THE PHYSICIANS
Kelly Khai Li Yap, M.D., Yiyi Yan, Aruna Chelliah
The study included 1226 patients with Type 2 Diabetes with 273 with A1c results greater than 8.5%. Among these 273 patients , 119 were not on insulin. A survey was conducted among the primary care physicians treating these patients to investigate the barriers insulin initiation .
45 % of the physicians responded
80 % of the responding physicians believed insulin was efficacious
90 % disagreed that insulin should be started by a endocrinologist
66 % chose to delay insulin therapy because it was to burdensome for their patients
60 % said that insulin therapy was to complicated for their patients and more than 50% said the variety
of insulin products lead to confusion.
" Our study suggests that education is the key to improving glycemic control and insulin usage among
patients managed by their PCPs."
Type 2 diabetes is a progressive disease leading to insulin deficiency and the need for insulin replacement . The convenience of oral diabetes medication and the increase complexity and risk of hypoglycemia with insulin is certainly a big factor in delaying insulin use . Also , many people on insulin still do not reach recommended target goals . A good example is , this study, 56% of patients were on insulin and still had an A1c greater than 8.5 % in order to qualify for this survey.
Looking at the data in studies like this does does not show the full picture of the long term diabetes management . It is easy to set and achieve ideal target goals for A1c , blood pressure and the other 7 risk factors in the ideal patient. Unfortunately many of us do not fall into that category . Age , general life situation and medication cost play an important role in trying to achieve ideal diabetes management. One size certainly does not fit all . It is important to remember , test result that are perfect for your neighbor may not be the best one for you.
The above problems in diabetes management was one of the main reason for me writing , Diabetes Office Visit and developing this web site . I believe , the key to success in a persons diabetes care is a well informed patient wanting to preserve their good health blended with the knowledge and wisdom of their health care provider . Setting , reaching and maintaining target goals in diabetes care is the secret to maintaining good health.
Know your treatment goals:
The informed patient knows the American Diabetes Association recommended goals and their
health care provider has the wisdom to help fit those goals into his / her individual life situation.
Ask for a copy of your laboratory test results.
Knowing your treatment goals simplifies your health care
If your laboratory or exam result is not at the mutually agreed goal .
Ask a simple question.
Doc. ( or other health provider ) , my test is not at our mutually agreed upon goal .
Can you help me fix it ?
Have fun , Be Smart and Check out the Diabetes Office Visit video above.
David Calder , MD
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