questin of the week

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Question fo the week:

What percentage of diabetics have goo control?

A. 7%

B. B. 14%

C. C. 43%

D. D. 63%

Answer and Critique (Correct Answer =A)

Diabetes is the seventh leading cause of death in the United States. The

high death rate is due in part to the many barriers to care, including

socioeconomic

factors. According to the National Health and Nutritional Examination Survey

(NHANES), only 7% of adults in the United States who have diabetes achieve

desired goals for glycemic control, blood pressure, and lipid levels. NHANES

also shows that only 37% of adults with diabetes achieve a hemoglobin A1c

value of less than 7%. These data underscore the important task that

physicians face in managing this complex illness. Physicians generally favor

the recommendations

of the American Diabetes Association and the American Association of

Clinical Endocrinologists, which call for tight glycemic control based on

hemoglobin

A1c measurements, with a goal of 6.5% or less in most cases. This goal must,

of course, be modified for elderly patients and for patients who have

problems

with or are at high risk of hypoglycemia. Also favored are achieving LDL

cholesterol levels less than 100 mg/dL (2.59 mmol/L) and blood pressures

less

than 130/80 mm Hg. Further recommendations are annual eye examinations and

tests for microalbuminuria in addition to biannual tests of the hemoglobin

A1c

level.

Key Point:

list of 1 items

.. In most American patients who have diabetes, the disease is poorly

controlled. More than 63% of patients who have diabetes have hemoglobin A1c

levels

exceeding 7%, and only 7% of adult patients who have diabetes in the United

States achieve the desired combined goals for glycemic control, blood

pressure,

and lipid levels.

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Bibliography

list of 3 items

1. National Health Examination Survey (NHANES), 1999-2000. Available at:

www.cdc.gov/nchs/about/major/nhanes/nhanes99_00.htm

.. Accessed 3 October 2006.

2. Saaddine JB, Engelgau MM, Beckles GL, Gregg EW, TJ, Narayan KM.

A diabetes report card for the United States: quality of care in the 1990s.

Ann Intern Med. 2002;136:565-74. [PMID: 11955024] [

PubMed]

3. Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular

disease among adults with previously diagnosed diabetes. JAMA.

2004;291:335-42.

[PMID: 14734596] [

PubMed]

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