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This marks the inaugural issue of a new publication from the American Diabetes Association (ADA), DOCNEWS. The "DOC" is not a play on words, but rather the acronym for one of the most important public health crises in the world: the triad of diabetes, obesity, and cardiovascular disease. The goal is to give the most important, timely, and easy-to-read information to primary care providers and all clinicians involved in the management of people with diabetes.
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Obesity is a burgeoning public health problem throughout the United States, where nearly two-thirds of the population exceed their normal weight range, and about 30 percent are obese.
Along with a long litany of devastating comorbidities, obesity is tilting the scales as a public health threat, on track to surpass smoking as the leading cause of preventable death in the United States next year, according to a recent report from the federal Centers for Disease Control and Prevention (CDC).1
Tobacco is still the top cause of avoidable deaths, claiming 435,000 lives, or 18.1% of the total. Poor diet and physical inactivity runs a close second at 400,000 lives (16.6%), according to CDC investigators. These numbers are a striking change from 10 years ago, when smoking accounted for 400,000 deaths (19%), while poor diet and physical activity killed 300,000 (14%).
Why do we need another medical publication? The answer is quite simple: DOCNEWS will be the first resource that integrates this cluster of conditions affecting all of our patients and, for that matter, our families. A recent school survey reported that 43% of eighth graders were obese, and almost 40% met the guidelines for pre-diabetes.2 In the 1990s, the number of individuals in the United States with diabetes increased by 60%.
With obesity and all its metabolic consequences occurring at younger ages, in children as well as adults, the impact on cardiovascular disease will be profound. Considering that people with diabetes are two to eight times more likely to die from cardiovascular disease than those without diabetes,3 both prevention and treatment of these conditions will become an even more focused part of medical practices for decades to come.
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DOCNEWS will spotlight clinical trials, both at scientific meetings (including those outside of the United States) and as published in diabetes and cardiovascular journals. We will address your specific questions in other ways, including having our editorial board of multidisciplinary experts publish answers to those issues that are particularly relevant. These areas of expertise include primary care, endocrinology, cardiology, pharmacology, nursing, and nutrition. Considering that a recent ACNielsen survey of 10,000 households reported that 36% had someone at home who was on a low-carbohydrate diet or had tried one makes the nutritionist a key resource for DOCNEWS.
It is my personal mission that we in the health professions continue to strive to improve the care of individuals with diabetes and obesity. For example, the national average of glycated hemoglobin (A1C) levels has actually increased over the past decade.4
Furthermore, only 7.3% of individuals with diabetes achieve the national goals for A1C, blood pressure, and cholesterol levels.5 What makes this particularly troubling is the strong possibility that our current guidelines for all three of these treatment goals could become more stringent in the near future.
We also want to inform our readers of key developments from the ADA with important ramifications for our patients. For instance, it was recently announced that the American Cancer Society, the American Heart Association, and the ADA are collaborating on a joint initiative to help lower the risk of cancer, diabetes, heart disease, and stroke (see story, page 9). The initiative will result in a comprehensive set of unified health recommendations for physicians, in addition to a public awareness campaign. With the growing public health impact of diabetes, obesity, and cardiovascular disease so apparent, it is hoped that this type of collaboration will be most effective in changing public health policies pertaining to screening, treatment, and lifestyle recommendations for all Americans at risk.
I trust you will find this and future issues of DOCNEWS informative.
All of us on the editorial board are excited to initiate this new endeavor by
the ADA. 
Footnotes
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References
2. Pilot feasibility study group of the studies to treat or prevent type 2 diabetes (STOPP-T2D) collaborative group: Obesity, diabetes and the metabolic syndrome in 8th grade children. Diabetes 53(Suppl. 2): A7, 2004.
3. Grundy SM, Howard B, Smith S Jr, et al: Prevention conference VI:
Diabetes and cardiovascular disease. Circulation 105: 2231–2239, 2002.
4. Coro CE, Bowlin SJ, Bourgeois N, Fedder DO: Glycemic control from
1988 to 2000 among U.S. adults diagnosed with type 2 diabetes.
Diabetes Care 27:17–20, 2004.
5. Saydah SH, Fradkin J, Cowie CC: Poor control of risk factors for
vascular disease among adults with previously diagnosed diabetes.
JAMA 291:335–342, 2004.
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| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |
