Magazine article Drug Topics

ADA Offers Revised Guidelines for Treating Diabetes Patients

Magazine article Drug Topics

ADA Offers Revised Guidelines for Treating Diabetes Patients

Article excerpt

The American Diabetes Association (ADA) has issued new guidelines for the diagnosis and treatment of a disease that affects some 16 million people in the United States. In general, they parallel past guidelines except for two things: recommended screening age and one of the criteria for diagnosing Type II diabetes in otherwise healthy individuals.

This year's standards recommend that a fasting blood glucose level of 126 mg/dl (7.0 mmol/l) or higher is sufficient reason for retesting, lowering the cutoff point from previous years' 140 mg/dl. Screening for Type II diabetes, previously suggested for those over 40, is now recommended for people over 45.

ADA president Mayer B. Davidson, M.D., said the fasting glucose threshold was changed to help identify more diabetics earlier in the course of the disease, so treatment can begin before tissue and organ damage make significant inroads. The age change was recommended to improve specificity of testing.

It's known that more people develop Type II diabetes in their 50s rather than their early 40s, he said. Therefore, raising the screening age by a few years is aimed at identifying more "positives" and, at the same time, making better use of scarce resources.

The new recommendations enlarge the net that health providers use to identify diabetics-and it's hoped the new dimensions will be effective, because an estimated eight million Americans have diabetes and don't know it. Lowering the fasting glucose threshold alone means that some two million Americans who might otherwise have gone untreated will be diagnosed, according to Wayne Weart, Pharm.D., professor and chairman of pharmacy practice at the Medical University of South Carolina in Charleston.

As for treatment, it would make a difference if the guidelines were followed, Davidson said. Too often, they are not, though they are evidence-based and represent best practice. If they were followed, "they would have a tremendous impact on the health of the diabetic population," he said.

Pharmacists are "the most accessible health-care professionals," said Anthony Graziano, R.Ph., owner of Green Hills Pharmacy in Parsippany, N.J., and are thus in an ideal position to help patients who are at risk or already diagnosed. First, using their knowledge of the patients they serve, they can urge those at high risk to seek testing. As for those who are diagnosed, pharmacists can help make sure patients are getting the care they need and that they're also pursuing the lifestyle modifications they must accomplish, such as quitting smoking or losing weight. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed


An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.