The Costly, Life-Disrupting Consequences of Poor Diabetes Care
Dr. Mohammed K. Ali, a preventive medicine specialist at Emory University who wrote a commentary about the study, said, “Many people are on high-deductible plans that don’t cover a lot of things that could help them. They may go to the pharmacy with a prescription and discover it’s not covered by their insurance or they can’t afford the co-pay.
“Yet,” he added, “we’re dealing with a chronic, progressive disease, and if you’re not on top of it, it will get on top of you very quickly.”
Dr. Kazemian explained, “Having a persistently high blood sugar level can damage the kidneys, heart, nerves and eyes; consuming a healthy diet with good portion control and getting regular exercise are critical to managing blood sugar.”
Dr. Rozalina G. McCoy, endocrinologist and primary care doctor at the Mayo Clinic in Rochester, Minn., said, “Diabetes is not just a clinical disease — it’s a public health disease that is multifaceted and very hard to manage.” High levels of blood sugar cause inflammation and damage blood vessels, both large and small, she said, and these vessels are found everywhere in the body, which is why so many systems are affected.
“But normalizing blood sugar alone will not fix the problem,” Dr. McCoy emphasized. “High blood pressure increases pounding on blood vessels, high cholesterol causes inflammation and blockages and smoking also causes inflammation.”
The new study, published in October in JAMA Internal Medicine, analyzed data gathered by the National Health and Nutrition Examination Survey from 1,742 nonpregnant adults with known diabetes and 746 adults with diabetes that had not been previously diagnosed. The data revealed that there had been no significant improvement in the diagnosis or treatment of diabetes from 2005 through 2016.
Ninety-four percent of those with known diabetes were receiving care for their disease, yet more than three-fourths failed to meet all four treatment goals established by the American Diabetes Association. The most common failing, afflicting 43 percent of those studied, was not maintaining a blood level of artery-damaging LDL-cholesterol of less than 100 milligrams per deciliter. This often happened because patients refused to take a statin or were not prescribed this cholesterol-lowering medication, Dr. Kazemian reported.