[PHNUTR-L] Growing diabetes epidemic: Patient/physician disconnect
on disease mgmt
Kathrynne Holden, MS, RD
fivestar at nutritionucanlivewith.com
Thu Jun 1 09:43:00 PDT 2006
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Public release date: 31-May-2006
Contact: Julia Gendler
julia.gendler at porternovelli.com
Growing diabetes epidemic: Patient/physician disconnect on disease
Diabetes experts share nationwide survey data, emphasize team approach
Washington, D.C. – Limited understanding of disease progression and
frustration with disease management contribute to the clinical challenge
of meeting the rising type 2 diabetes epidemic in America, according to
the Diabetes Roundtable. The Roundtable, a multidisciplinary group of
diabetes experts convened by the American Association of Diabetes
Educators (AADE) and the American Association of Clinical
Endocrinologists (AACE), with support from Merck & Co., Inc., calls for
the medical community to take a more collaborative approach to caring
for people with type 2 diabetes as a way to improve both disease
management and outcomes.
A Harris Interactive (R) survey commissioned by AADE suggests a
disconnect between what patients with type 2 diabetes and primary care
physicians who treat the disease believe is the state of diabetes
management. For example, two-thirds of patients (69 percent) say they
feel very knowledgeable or knowledgeable about managing their condition.
At the same time, 81 percent of physicians surveyed say they are
frustrated with the number of their type 2 diabetes patients who do not
follow their treatment regimen exactly as prescribed. The survey also
shows gaps in understanding of the disease itself. Half of patients
surveyed say they have little or no understanding of their A1C level or
in the past six months have not had it checked or are unsure if they
have had it checked. A1C is basic lab test for evaluating glucose
control, an important aspect of diabetes management.
"We are dealing with some critical information gaps," said S. Sethu K.
Reddy, M.D., M.B.A., F.A.C.E., F.A.C.P., chairman and program director
of the Department of Endocrinology, Diabetes and Metabolism at The
Cleveland Clinic and a member of the Diabetes Roundtable. "Type 2
diabetes is a chronic and complex disease, and for patients to
self-manage their condition, it is useful for them to fully understand
the basics of the disease and its progression--such as the role of
declining pancreatic beta cell function. Yet, the majority (78 percent)
of the primary care physicians surveyed say insulin resistance is the
most important contributor to, and is primarily responsible for, the
progression of type 2 diabetes in the majority of their patient
population, with only 20 percent saying it is beta cell dysfunction.
This suggests that primary care physicians do not consistently focus on
how beta cells in the pancreas work, including as they relate to the
incretin system. I also think most physicians don't clearly realize that
beta cell function may play a role in determining how well patients
respond to oral agents in diabetes."
The Roundtable advocates for improvements in the current diabetes care
system, including the use of available resources to help patients best
manage the disease. The survey shows 59 percent of patients surveyed
have worked with a diabetes educator. Almost four in five patients
surveyed (78 percent) who have not worked with a diabetes educator would
like to learn something from one, including how to reduce the risk of
diabetes complications (39 percent), strategies for healthy eating (38
percent), and information on new type 2 diabetes medications (33
percent). Additionally, the survey shows that diabetes educators have
had a positive impact on how knowledgeable patients feel about managing
"We are not making the best use of our resources for managing type 2
diabetes. All too often patients feel they have 'failed' and feel
guilty; physicians feel frustrated; no one wins," said Diabetes
Roundtable member Donna Rice, M.B.A., R.N., B.S.N., C.D.E, wellness
program manager, Botsford General Hospital, Novi, MI and president-elect
of AADE. "Increasingly we recognize that a team-centered approach
involving the patient, primary care physician, diabetes educator,
behavioral scientist and endocrinologist provides the support and
resources best needed to help patients manage the disease."
Members of the Roundtable believe care for people with type 2 diabetes
could be enhanced by regular treatment from a team that aligns the
latest in science, treatment options and education around lifestyle
behavior change. In an effort to begin developing a roadmap to improve
collaboration between the many areas of care directly involved in type 2
diabetes treatments, the Roundtable plans to work with other
professional and patient groups to begin identifying potential solutions.
For further information on the outcomes of the Roundtable meeting and
survey results, visit www.diabetesteamsite.com.
About the Diabetes Roundtable
AADE and AACE convened the Diabetes Roundtable in April 2006, to discuss
ways to improve outcomes for type 2 diabetes. The multidisciplinary
group of health care professionals includes experts in endocrinology,
diabetes education, primary care and behavioral science. In addition to
Dr. Sethu Reddy and Donna Rice, other members of the Roundtable are:
Susan Cornell, Pharm.D., B.S., C.D.M., C.D.E., clinical assistant
professor, Midwestern University, Downers Grove, IL; Silvio Inzucchi,
M.D., professor of medicine, Section of Endocrinology, Department of
Internal Medicine, Yale University, Director, Yale Diabetes Center, New
Haven, CT; Edwin Fisher, Ph.D., chair, Health Behavior and Health
Education, University of North Carolina, Chapel Hill, NC; and Doron
Schneider, M.D., associate program director of the Internal Medicine
Residency and Medical Director of the Ambulatory Services Unit, Abington
Memorial Hospital, Abington, PA. The nationwide survey and the Diabetes
Roundtable were supported by a grant from Merck & Co., Inc.
Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
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