The prevalence and incidence of diabetes is increasing worldwide. In the United States, over 25 million people (8.3% of the population) have diabetes, 7 million of which have not been diagnosed. There were 1.9 million new adult diagnoses in 2010 alone, and an alarming 79 million Americans are at risk of developing diabetes. Type 2 is the most common form, affecting 90-95% of adults diagnosed with diabetes. Diabetes is the seventh leading cause of mortality, and the risk of death amongst people with the disease is twice that of people without diabetes of a similar age. Diabetes is also the leading cause of kidney failure, lower limb amputations, and blindness in the United States, and is one of the leading causes of heart disease and stroke. Due to the complexity of the disease and its comorbidities, management of diabetes can be complicated. The advent of new drugs and treatment options adds another layer of complexity, making it difficult for primary care providers to make decisions surrounding optimal treatment plans. According to the Centers for Disease Control, approximately 60 percent of people with diabetes do not achieve their target blood sugar levels with their current treatment regimen. (Saydah SH, Fradkin J and Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA. 2004;291:335-42). The financial burden of diabetes is huge: total treatment costs in the United States add up to approximately $174 million per year.
Unfortunately, Monroe County is behind the curve with regards to the diagnosis and treatment of diabetes. According to the CDC, 8.5% of adults in Monroe County have been diagnosed with diabetes and 30% of adults in Monroe County are considered to be obese. The shortage of endocrinologists in Rochester and surrounding areas (there are approximately 12 full-time endocrinologists, or one endocrinologist for every 6900 individuals with diabetes), means that primary care providers in this region carry the burden of trying to prevent, diagnose and treat diabetes and its associated complications.
This web-based Continuing Medical Education activity seeks to provide primary care physicians, pediatricians, mid-level providers, endocrinologists, nephrologists, dieticians, and other allied health professionals with updates in diabetes research and treatment options, including the importance of taking a multifaceted and patient-centered approach to diabetes care. (Although diabetes management generally begins with diet and exercise, as the disease progresses over time, treatment options will be required to control blood sugar levels, blood pressure, cholesterol and triglycerides - microvascular and/or macrovascular complications.)
At the conclusion of this activity, participants should be able to:
- Describe the signs and symptoms of hypoglycemia.
- Develop strategies to avoid hypoglycemia in patients taking medications for diabetes.
- Explain how to make the diagnosis of PCOS and how to treat PCOS depending on the patients specific concerns.
- Discuss the barriers that patients face when trying to treat their diabetes and list personal approaches to overcome these barriers.
- Develop a diet and exercise plan that fits the specific needs of each of their diabetes patients.
- Explain the difficulties facing diabetic children and their families and develop strategies to help overcome these difficulties.
- Identify the benefits and risks of incretin therapy in diabetes.