JULY 01, 2008

Kids with Diabetes: Ketoacidosis Common at Diagnosis

Diabetic ketoacidosis, which makes the blood more acidic than normal, is a potentially life-threatening condition at the time of a diabetes diagnosis for nearly 30% of children with type 1 diabetes and 10% of those with type 2 diabetes.

The Search for Diabetes in Youth Study included 3666 patients who were diagnosed with diabetes before age 20 in US study areas from 2002 to 2004. The researchers conducted a medical review for 2824 of the patients to determine the presence of ketoacidosis.

The findings, reported in Pediatrics (May 2008), indicate that overall 25.5% of the patients had the condition when diagnosed with diabetes. As the participants got older, the proportion decreased, ranging from 37.3% in children younger than 5 years to 14.7% in 15- to 19-year olds.

Furthermore, about half of the participants were hospitalized at diagnosis. The percentage of patients hospitalized with ketoacidosis was 93%, compared with 41% of patients without the condition.

Campaign Targets Type 2 Diabetes

The National Diabetes Goal initiative seeks to encourage prevention and ensure that, by 2015, 45% of Americans who are at risk for type 2 diabetes will know their blood glucose level and how to manage the disease. For individuals who have blood glucose levels in the prediabetes range, lowering blood glucose levels can help prevent or delay the onset of the disease.

The program was launched by the National Changing Diabetes Program. The National Association of Chain Drug Stores (NACDS) has joined the effort. ?America?s pharmacies play a pivotal role in helping patients manage diabetes and other chronic diseases,? said Steven C. Anderson, IOM, CAE, NACDS president and chief executive officer.

Diabetes Drugs Top Drug Spending Growth

Medco Health Solution Inc?s 2008 Drug Trend Report found that spending on diabetes treatments has increased 12%, surpassing cholesterol drug spending. The increase is attributed to a shift toward higher-cost treatments, brand name drug price inflation, and moderate growth in the number of patients getting treatment.

Although use of diabetes medications increased only 2.3% during 2007, the cost of diabetes treatments rose sharply as patients moved to new drugs.

The newly available treatments have advantages over older drugs because they are faster-acting and can help patients maintain consistent blood sugar levels to prevent complications from the disease.

Quality of Life Impacts Lifespan

Quality of life is a factor in longevity for patients with diabetes, according to a study reported in Diabetes Care (May 2008). The study included 1143 Dutch adults with type 2 diabetes.

Quality of life was associated with death risk, independent of a range of factors in adults with the disease. Using a standard survey on health-related quality of life completed by the participants, the patients who scored below the median for physical well-being were 2 times as likely to die over the next 6 years, compared with those who scored higher.

The researchers concluded that the results should give physicians ?added incentive? to ask patients with diabetes about their quality of life and address any problems when possible.

Do Diabetics Get Necessary BP Treatment?

A study of 1169 patients with diabetes and high blood pressure (BP) have only a 50?50 chance that their physicians will change their medications as necessary or offer other treatment options, according to a study reported in the Annals of Internal Medicine (May 20, 2008).

For the study, the researchers collected data on the patients who received care from the US Veterans Administration during a 1-year period. The patients were seen at 9 different sites in 3 states. At the study onset, all the patients had high BP (140/90 mm Hg or higher). The BP goal for patients with diabetes is 130/80 mm Hg. The researchers found that 49% of the patients had their BP medication treatment changed during a clinic visit. This meant that the patients received either a new medication, a change in dose of current medication, or a plan to follow up within a month.

F A S T   F A C T : From 1980 to 2005, diabetes among women increased 76%.