DIABETES WATCH

Kids with Diabetes:Ketoacidosis Common at Diagnosis

Diabetic ketoacidosis, which makesthe blood more acidic than normal, is apotentially life-threatening condition atthe time of a diabetes diagnosis for nearly30% of children with type 1 diabetesand 10% of those with type 2 diabetes.

The Search for Diabetes in YouthStudy included 3666 patients who werediagnosed with diabetes before age 20in US study areas from 2002 to 2004.The researchers conducted a medicalreview for 2824 of the patients to determinethe presence of ketoacidosis.

The findings, reported in Pediatrics(May 2008), indicate that overall 25.5%of the patients had the condition whendiagnosed with diabetes. As the participantsgot older, the proportiondecreased, ranging from 37.3% in childrenyounger than 5 years to 14.7% in15- to 19-year olds.

Furthermore, about half of the participantswere hospitalized at diagnosis.The percentage of patients hospitalizedwith ketoacidosis was 93%,compared with 41% of patients withoutthe condition.

Campaign TargetsType 2 Diabetes

The National Diabetes Goal initiative seeks to encourageprevention and ensure that, by 2015, 45% of Americans whoare at risk for type 2 diabetes will know their blood glucoselevel and how to manage the disease. For individuals whohave blood glucose levels in the prediabetes range, loweringblood glucose levels can help prevent or delay the onset ofthe disease.

The program was launched by the National ChangingDiabetes Program. The National Association of Chain DrugStores (NACDS) has joined the effort. ?America?s pharmaciesplay a pivotal role in helping patients manage diabetes andother chronic diseases,? said Steven C. Anderson, IOM, CAE,NACDS president and chief executive officer.

Diabetes Drugs TopDrug Spending Growth

Medco Health Solution Inc?s 2008 Drug Trend Report foundthat spending on diabetes treatments has increased 12%, surpassingcholesterol drug spending. The increase is attributed toa shift toward higher-cost treatments, brand name drug priceinflation, and moderate growth in the number of patients gettingtreatment.

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

The newly available treatments have advantages over olderdrugs because they are faster-acting and can help patientsmaintain consistent blood sugar levels to prevent complicationsfrom 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 ofa range of factors in adults with the disease. Using a standardsurvey on health-related quality of life completed by the participants,the patients who scored below the median for physicalwell-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 abouttheir quality of life and address any problems when possible.

Do Diabetics Get Necessary BP Treatment?

A study of 1169 patients with diabetesand high blood pressure (BP) haveonly a 50?50 chance that their physicianswill change their medicationsas necessary or offer other treatmentoptions, according to a study reportedin the Annals of Internal Medicine (May20, 2008).

For the study, the researcherscollected data on the patients whoreceived care from the US VeteransAdministration during a 1-year period.The patients were seen at 9 differentsites in 3 states. At the study onset, allthe patients had high BP (140/90 mmHg or higher). The BP goal for patientswith diabetes is 130/80 mm Hg. Theresearchers found that 49% of thepatients had their BP medication treatmentchanged during a clinic visit. Thismeant that the patients received eithera new medication, a change in dose ofcurrent medication, or a plan to followup within a month.

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