Navigation Links
Editorial illustrates shift away from glycemic control in diabetes treatment
Date:2/20/2014

BOSTON (February 20, 2014)An editorial in a February issue of American Family Physician proposes a simple way for physicians to communicate with patients about the best treatments for diabetes. The "lending a hand" illustration reprioritizes treatment goals, based on research on mortality reduction, to convey that glycemic control is no longer the primary intervention.

In order of benefit, to improve length and quality of life, patients with type 2 diabetes benefit from these interventions, starting with smoking cessation:

"Glycemic control is stuck in people's minds as the primary goal of treatment, but evidence has existed since the 1970s that other interventions are of greater benefit," said senior author Allen Shaughnessy, Pharm.D., M.Med.Ed., professor of family medicine at Tufts University School of Medicine and fellowship director of the Tufts University Family Medicine Residency Program at Cambridge Health Alliance.

Shaughnessy and colleagues wrote the editorial on their "lending a hand" illustration to demonstrate the paradigm shift in treatment priorities. "Lending a hand" emphasizes interventions that improve length and quality of life for those living with type 2 diabetes, in line with new guidelines from the American Diabetes Association and the European Association for the Study of Diabetes.

The "lending a hand" illustration uses the fingers of an open hand to depict diabetes interventions from thumb to pinky in descending order of benefit, relative to complications and mortality. Smoking cessation is considered the most important intervention (the thumb). Blood pressure control, metformin drug therapy, and lipid reduction follow along the pointer to ring finger. Glycemic control, considered the least important intervention, is relegated to the pinky.

"Some degree of glycemic control is necessary to prevent symptoms," Shaughnessy said. "It's just that the return on investment is low when we try to push patients with diabetes to get their blood glucose as close as possible to normal."

According to the National Diabetes Information Clearinghouse, approximately 25.8 million Americans have diabetes, and seven million of those may not be diagnosed. The NDIC further estimates that type 2 diabetes accounts for 90-95 percent of all cases of diabetes. Diabetes is a major cause of heart disease and stroke and the leading cause of new cases of blindness among adults.

"Our aim in proposing "lending a hand" is to communicate the most beneficial interventions patients can make to reduce their symptoms and risk of death from diabetes complications. But this model requires a shift in thinking away from the outdated idea that glucose reduction is most important, which may be a challenge," said first author Deborah Erlich, M.D., M.Med.Ed., assistant professor at TUSM, assistant family medicine clerkship director, and program director of the new Carney Family Medicine Residency, a TUSM affiliate.

"Working to control blood glucose while not addressing the other risk factors first is like rearranging deck chairs on the Titanic. The ship's going down," said author David Slawson, M.D., professor and vice chair of the department of family medicine, director of the Center for Information Mastery, and director of the family medicine fellowship at University of Virginia School of Medicine.


'/>"/>
Contact: Siobhan Gallagher
Siobhan.gallagher@tufts.edu
617-636-6586
Tufts University, Health Sciences Campus
Source:Eurekalert  

Related medicine news :

1. Beta blockers and perioperative care: EHJ editorial addresses controversy
2. Career Step Physician Advisor Joins the ICD10monitor’s Editorial Board
3. Illustration Source, a Leading Provider of Distinctive Stock Illustration to Corporate, Financial and Editorial Clients, Announces New Work by Illustrator Warren Gebert
4. I THESIS EDIT creates editorial team for medical research editing
5. BMJ editorial: Indias research participant protection policy
6. Sofia University Ryan Rominger to Serve on Academic Editorial Review Board for SAGE Publications (London Division)
7. Women and Infants Maternal-Fetal Medicine specialist selected for editorial team
8. Editorial calls for comprehensive approach to cancer screening
9. “Benefits of Aloe Vera,” A New Article On Vkool.com Illustrates the Advantages of Aloe Vera - V-kool
10. New report illustrates persistent global burden of anemia among high-risk populations
11. New Book "Praying Our Way through Stress" Illustrates How to Overcome Stress with Love
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Editorial illustrates shift away from glycemic control in diabetes treatment
(Date:5/28/2016)... ... ... a half of planning the Multiple Pathways of Recovery Conference , CCAR is pleased ... held May 2 -4, 2016 at the Mystic Marriott Hotel & Spa . ... pathways individuals use to get into and sustain their recovery. Pathways of recovery are ...
(Date:5/27/2016)... ... ... Two director-level employees of Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ) ... The award recognizes businesswomen who excel in their fields and who have made significant ... Long-Term Services and Supports) Program at Horizon NJ Health and Theresa Ponton, Director of ...
(Date:5/27/2016)... ... May 27, 2016 , ... This campaign aims to provide a path to ... society can control and change. , As nearly 795,000 Americans suffering from a new ... United States. Plus, with an estimated 129,000 of these people dying from stroke, it’s ...
(Date:5/27/2016)... , ... May 27, 2016 , ... ... installment is bolstered by inspiring human interest stories, courtesy of leaders in the ... and tech within the industry, from leading advocates and associations—namely Jones & Bartlett ...
(Date:5/26/2016)... ... ... Despite last week’s media reports hinting at a June rate hike after ... 2017 for an interest rate increase, according to Rajeev Dhawan of the Economic Forecasting ... Open Market Committee (FOMC) dot charts are of interest to the press for their ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... May 25, 2016  Zymo Research Corp. announced ... new reference materials that help researchers obtain the ... to analyses. The rapid growth of the study ... to have standard methods to improve the reproducibility ... inherently exist at every step of the measurement ...
(Date:5/25/2016)... 2016 Digital Health Dialog, LLC dba ... the US Patent and Trademark Office of U.S. ... processes for electronic opt-­in and processing of discount ... HIPAA compliance and otherwise. Logo - ... "Our technology allows for individuals to opt­-in ...
(Date:5/24/2016)... May 24, 2016 Cirujanos holandeses ... ayudar a los médicos a compartir sus mejores prácticas ... escala mundial. Profesionales médicos de Europa, África, ... apuntado a la aplicación, que combina la transmisión en ... totalmente seguro. Educación   "Imagine un ...
Breaking Medicine Technology: