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Diabetes
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The situation:
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
There are 20.8 million children and adults in the United States, or 7% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, unfortunately, 6.2 million people (or nearly one-third) are unaware that they have the disease. Diabetes goes hand in hand with obesity, and both are dramatically increasing over time in the US. (Fig 1)
In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes.
In a recent survey of 2,000 people with diabetes:
• 68% do not consider cardiovascular disease to be complication of diabetes
• 50%+ don’t feel risk for heart condition or stroke
• 60% don’t feel at risk for high blood pressure or cholesterol
In fact, more than 65% of people with diabetes die from heart disease or stroke. With diabetes, heart attacks occur earlier in life and often result in death.
The problem:
Diabetes is a difficult disease to manage. Diabetic involves much more than blood gluclose monitoring. Diabetics commonly develop kidney, stomach, vascular and eye problems. Currently, only 24% of diabetics have their HbA1c measured. The HbA1c determines your average gluclose level over the past three months and is the primary measure of proper gluclose control. Less than 60% have an annual eye or foot exam, and only 20% are taking aspirin to protect against heart attacks.
The Santé solution:
In 2001, the Task Force on Community Preventive Services “strongly recommended” a disease management approach to treating patients with diabetes. Such an approach uses an integrated team who can attend to the entire range of existing and potential complications. At Santé, that is our goal. Recent studies have shown that aggressive monitoring results in better outcomes. For patients with insulin requiring diabetes, this intensive program included several key elements. (Fig 2)
Adhearance to this program resulted in significantly fewer complications: (Fig 3)
At Santé, we will coordinate your diabetic care in a holistic approach, thus offering you the best chance of avoiding complications.
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