Quality
of U.S. Diabetes Care is Below Standard!
The
level of care that diabetes patients receive in the United States
falls far below current national recommendations, that from the
Annals of Internal Medicine.
The first, the Third
U.S. National Health and Nutrition Examination Survey (NHANES III)
ran from 1988 to 1994, and the second, from the Behavioral Risk
Factors Surveillance System (BRFSS), gathered information in 1995.
All the people in the study, 1,026 from NHANES III and 3,059 from
BRFSS, were between 18 and 75 years old and had been diagnosed
with diabetes.
Diabetes
is a serious disease, but most of the complications could be
prevented or delayed with the appropriate treatment and
interventions.
Diabetes
care in the United States can be vastly improved and such
improvement, may yield substantial health benefits.
Overall,
only
about 30% of the respondents had had their hemoglobin A1c,
which measures long-term blood sugar control, tested during the
previous 12 months and 18% of them had levels greater than 9.5%,
indicating that their blood sugar was poorly controlled. Further,
only about 4 in 10 respondents said they monitored their blood
glucose level at least once every day.
Roughly
one third of respondents reported having
poorly controlled blood pressure,
about
37% said they did not have annual dilated eye examinations
and
45% said they did not undergo annual foot exams.
People
with diabetes face a high risk of blindness, which is why they are
urged to have eye exams annually. Foot exams are also crucial
because people with diabetes can develop sores on their feet that
can become infected and ultimately lead to the need for
amputation.
"When
applied to the estimated 7.9 million persons 18 to 75 years of age
in the United States who have diagnosed diabetes, these statistics
translated to an estimated.1.4 million persons with hemoglobin A1c
levels greater than 9.5%, 2.7 million with uncontrolled blood
pressure, 2.9 million without annual dilated eye examinations, and
3.6 million without annual foot examinations. Annals
of Internal Medicine April, 2002;136:565-574
