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This fall, the Board of Health is expected to vote on a proposal to monitor people with diabetes by requiring city laboratories to report all glycated hemoglobin (A1C) test results.
The goal is to learn how people with diabetes are managing their blood glucose levels. Officials say the information would provide them with the most extensive system in the nation for tracking control of diabetes.
DOC News asked:
How might surveillance of diabetes improve prevention and treatment?
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This is a good initiative as long as they're protecting patients' confidentiality and following all of the guidelines.
I've never heard of something of this magnitude before, so we can't know for sure whether it will improve treatment and care. We do know from studies and clinical trials that when you have more intensive monitoring of diabetes, more intensive education provided by diabetes educators and registered dietitians, and physicians who are knowledgeable and more aggressive in controlling blood sugars, diabetes can be managed.
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Joanne Shearer, RD, MS, CDE, LN Team Leader, Hospital Food and
Nutrition Services Sioux Falls, S.D.
We [could] use this market of A1C levels for a lot of outcomes to determine whether management of someone's diabetes is effective or even adequate. If they do something with the information, it might be very helpful to a patient who doesn't have access to the health care to get [A1C] down.
Tricia D. Hawkins, RN, CDE Case Manager Springfield, Va.
I disagree with that because I'm not certain of how it [the database] would be used, and it lends itself to a high chance for misuse. Those are my reservations. It would lend itself to better treatment and prevention, though.
Charles Graber, RN Hospice Staff Nurse Newton, Kan.
TALK BACK: QUESTIONING METABOLIC SYNDROME
Metabolic syndrome is commonly described as a group of interrelated health factors that create an increased risk for heart disease when they appear together. The factors include—depending on which definition one subscribes to—high blood pressure, glucose intolerance, dyslipidemia, large waist size, and signs of kidney disease. Each of the contributors to the syndrome is known to increase the risk for cardiovascular disease.
In September, the American Diabetes Association and the European Association for the Study of Diabetes published a joint statement suggesting that metabolic syndrome isn't really a syndrome and should not be a diagnosis used in primary care1 (DOC News, October 2005). Others say the term is an important way to educate patients about the connection between their lifestyle, health risks, and medical outcomes.
What do you think? Does the presence of metabolic syndrome show a greater risk for heart disease than the sum of its component risks? What is the value in primary care practice of diagnosing patients with metabolic syndrome?
Send your comments to docnews{at}diabetes.org.
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| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |
