Conundrum: How to Translate Knowledge and Implications of Pathophysiology, Progression and Complications of Diabetes to Prevention,Early Diagnosis.

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Presentation transcript:

Conundrum: How to Translate Knowledge and Implications of Pathophysiology, Progression and Complications of Diabetes to Prevention,Early Diagnosis and Optimal Treatment of Diabetes and its Complications…….

Especially when One looks at the: Reality of Diabetes Care Practices, USA

Diabetes in the United States 15.6 million individuals with diabetes (~7.8% ) >30% of individuals > 60 yrs have DM or IFG Only ~ 2/3 are diagnosed and under Rx Only ~ 5.1 million are appropriately treated Less than 8% are under the care of an endocrinologist or diabetologist - and we can’t take care of them all Harris. Ann Int Med. 1996; 124:117

Diabetes Care in an HMO Setting Frequency of Assessment HbA1c FPG Urine Prot Eye Exam Foot Exam Chol Peters AL et al. Diabetes Care. 1996;19:601-606.

Mean FPG in Type 2 Diabetes - USA Community Studies 11.1 13.9 8.3 5.6 2.8 Non Diab 9 Studies of Diabetic Populations in USA Mean FPG (mg/dL) Mean FPG (mmol/L) Diabetes in America 1995.

Glycemic Control in A Population Based Sample of Type 2 Diabetes NHANES III Sample: 1480 People with Type 2 Diabetes % Achieving ADA Goal of HbA1c < 7.0% Harris et al. Diabetes Care. 1999;22:403.