Diabetes Watch

Pharmacy TimesAugust 2009
Volume 75
Issue 8

Brought to you by Takeda

Diabetes Rate Growing

A WilsonRx survey of 34,454 household health care decision makers showed that 25.7% of households have at least one member with diabetes. The figure represents an increase from 15.8% of households surveyed in 2001. Furthermore, diabetes households filled 44% more prescriptions in the past year, compared with nondiabetic households.

The survey also showed that patients with diabetes have greater use of health care services, including visits to primary care and specialty physicians, hospital admissions, outpatient visits, and pharmacy visits. Despite the increasing treatment prevalence and availability of more treatments, only 1 of 3 patients feel in control of their diabetes.

“Unfortunately, we found...that 26% of diabetes households did not refill all of their prescriptions and 70% report that they did not take their medications as prescribed,” said Jim Wilson, president of Wilson Health Information.

Panel Recommends A1C Test for Diabetes Diagnosis

The A1C test should be the primary tool used to diagnose diabetes, recommended an international expert panel at the recent American Diabetes As sociation (ADA) annual meeting. In addition to providing a more accurate diabetes risk, the test does not require fasting as do many older tests.

Patients with hemoglobin A1C values ≥6.5% can be considered to have diabetes, but the number is not set in stone. The recommendation is based on a review of literature, focusing on what A1C levels were more likely to result in diabetic retinopathy.

The committee included members of the ADA, the International Diabetes Federation, and the European Association for the Study of Diabetes. These organizations have not yet issued position statements on the recommendations. The guidelines were published in the July 2009 issue of Diabetes Care.

Heart Risks Lower with Strict Blood Sugar Control

Patients with diabetes looking to lower their odds of heart attack and cardiovascular disease should strictly control their blood sugar levels, according to a study reported in the May 23, 2009, issue of The Lancet.

For the study, the researchers analyzed data from 5 studies that included 33,040 patients. Among these patients, there were 1497 heart attacks, 2318 cases of coronary heart disease, and 1127 strokes, and 2892 patients died. Reviewing the hemoglobin A1C (HbA1C) concentration in patients, the investigators determined the more intensive blood sugar control was reached when patients used additional medications and/ or higher doses to achieve lower HbA1C levels.

The patients who received intensive treatment to control their blood sugar had an HbA1C that was 0.9% lower, compared with the patients getting standard treatment (6.6% vs 7.5%).

Sleep Apnea: Undiagnosed in Obese Patients

Sleep apnea often goes undiagnosed in patients battling type 2 diabetes and obesity. The study reported in the June 2009 issue of Diabetes Care found that 87% of the 306 study participants had sleep apnea but were never diagnosed with the disorder.

The findings are based on the patients’ responses to questions on sleep apnea symptoms. The researchers determined that >30% of the patients had 16 to 20 episodes per hour in which their breathing would stop during sleep, and 22% had >30 episodes an hour, which is considered severe sleep apnea.

Study Shows Coffee Consumption OK

Men with type 2 diabetes can continue to drink coffee, even large quantities, without raising their chances of developing heart disease or increasing their risk of dying early. The study included 3497 men with diabetes who were followed from 1986 to 2004. The data indicated that none of the participants had cardiovascular disease at study onset, and they all completed several dietary questionnaires during followup.

Reporting in the June 2009 issue of Diabetes Care, the researchers found that even consuming ≥4 cups of coffee per day did not dramatically raise the risk of heart disease or premature death during the study, compared with patients who did not drink any coffee. “Our findings do not support the hypothesis that habitual caffeinated coffee consumption increases the risk of cardiovascular events or mortality among individuals with type 2 diabetes,” concluded the researchers.

For pharmacist-recommended diabetes products, visit: WWW.OTCGUIDE.NET.

FAST FACT: Women who have had gestational diabetes have a 20% to 50% chance of developing diabetes in the next 5 to 10 years.

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