Diabetes
Prevention Falls Short, Far Short
States
are far from meeting 2010 goals.
Americans with diabetes aren't receiving preventive
treatments as often or as thoroughly as they should, a new study
says.
Despite
a variety of outreach efforts, preventive care for adults with
non-insulin dependent diabetes (Type II) differs vastly depending
on factors like age, race and income, according to the government
scientists who prepared the report.
The
findings, which are intended to be a benchmark for education
efforts in the coming decade, shows that it's clear there's plenty
of room for improvement says the Centers for Disease Control and
Prevention in Atlanta.
"Some
people feel that you can't do anything about diabetes. Our take on
that is that [patients] can do something about it to either delay
or prevent the onset of complications. You can be in control, you
can improve your outcome, but it's going to take work."
More
than 15 million Americans have diabetes. Most have the
adult-onset, or Type II, form of the condition, in which their
cells lose their sensitivity to the hormone insulin, which helps
the body extract sugar from blood.
The
number of Americans with diabetes rose 33 percent between 1990 and
1998, the CDC says, thanks largely to a jump in how fat people are
becoming.
Although
diabetes can be easily controlled -- with drugs, regular
injections of insulin, changes in diet and exercise -- if
unchecked it can cause serious health problems and even
death.
Diabetes
is the leading cause of adult blindness and a major source of
kidney, heart and vessel disease, health officials say. Nerve
damage from the condition leads to more than 56,000 amputations a
year, more then half of which could be prevented, experts
say.
The
study, based on a phone survey between 1997 and 1999, focused on
several key measures of preventive treatment for diabetics: blood
sugar self-testing, eye exams to watch for signs of blindness
linked to the disease, and foot exams to catch nerve and tissue
damage that can lead to amputation. They also looked at rates of
another blood test, for a protein called HbA1C, which marks the
progress of the disease.
For
all gauges, the average percentages of diabetics who reported
receiving these tests were far below the health goals set for the
year 2010, which themselves stop below 80 percent of all
patients.
Sugar
monitoring rates ranged from about 30 percent of people surveyed
in Hawaii, to 65.5 percent in Montana -- the only state to meet
the 2010 goal of 60 percent. The percentage of people receiving
yearly eye exams ranged from 47 percent in Arkansas to 81 percent
in Massachusetts, one of just three states to meet the 2010
guideline of 75 percent for this test.
No
state met the 2010 yardsticks for either annual foot exams or the
HbA1C screening.
The
use of preventive care ranged widely from state to state, but was
generally low in the south and higher in the northeast, the
researchers say. Age was a factor, too. People over 45 were more
likely to have an annual eye exam, while those over 75 were less
likely to check their own blood sugar, the study found.
"It's
really not clear from our data why some states are lower that
others," Tierney says. Possible factors include differences
in demographics, attitudes among patients, variations in the way
doctors practice medicine, and social and economic forces, he
says. Not surprisingly, patients without health insurance were
less likely to report getting preventive care for their
diabetes.
What
To Do
Outreach
efforts to patients and physicians should help improve access to
preventive care, as
should the increasing numbers of health insurers that are
incorporating diabetes management into their treatment guidelines.
FACT:
More
than 270,000 Americans have advanced kidney disease.
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