Diabetes Watch

Pharmacists Counsel, Educate Diabetes Patients

As the number of individuals with undiagnosedand diagnosed diabetes rises,there is an even greater need for pharmaciesto offer specialized care for thispatient population.

Medicine Shoppe and Medicap Pharmacieshave 100 stores that now operateSpecialized Care Centers for diabetes(SCC-Diabetes), helping patientsbetter understand their illness and track,analyze, and comply with their physicians'recommendations. As part of theprogram, nearly 200 pharmacists havereceived certification as diabetes managers.

The pharmacies operating an SCCDiabetesCenter provide patients withquarterly educational programs or supportgroups on topics affecting patientswith diabetes; monthly downloads ofblood glucose meter reports (consentingpatients also can have the reportsent to their physician free of charge);training on blood glucose monitors andinsulin pens; and informational materialsfrom pharmaceutical manufacturers.The pharmacies also offer personalized,monthly counseling sessions with educationalmaterials to assist patients inmanaging diabetes.

Two-prong ApproachUrged for Prediabetes

Experts from the American Association of Clinical Endocrinologists(AACE) recommend that lifestyle modifications,along with a reduction in heart disease risks will help preventprediabetes from progressing to the full-blown disease.

The first step is lifestyle changes such as diet and exercise.The AACE also thinks that prediabetes needs to be treated moreaggressively. Because no drug therapies for treating prediabeteshave been approved by the FDA, the AACE has proposed analternative: reduce the number at which blood sugar levels definediabetes. The change would make current medications availableto patients who are now classified as prediabetic. Patients whocannot modify their cardiovascular risk with lifestyle changesneed to be treated for hypertension and high cholesterol andshould have medications to control blood sugar levels.

Undiagnosed Diabetes:HbA1C Test May Help

A national panel of health care experts suggests that thehemoglobinA1C (HbA1C) test used to monitor patients withdiabetes may also help in identifying individuals with undetecteddiabetes.

In a consensus statement, published in the July 2008 issueof the Journal of Clinical Endocrinology and Metabolism, theresearchers concluded that the HbA1C test should be usedas a front-line method for detecting patients with the disease,especially for those at high risk for diabetes. The test does notrequire fasting and is not affected by short-term changes in dietand exercise.

The consensus group recommended that patients who scoreat least 6% on the HbA1C test may have or be at risk for diabetesand should be monitored with additional glucose or HbA1Ctests. The patients who score 6.5% and above, if confirmed,should be considered to have diabetes.

Gestational Diabetes UpsType 2 Diabetes Risk

Gestational diabetes greatly increases a woman's risk ofdeveloping type 2 diabetes later on, according to a new studyreported in the July 29, 2008, issue of the Canadian MedicalAssociation Journal.

Diagnosing and treating type 2 diabetes is critical if a womanplans to become pregnant again, because poorly controlleddiabetes in pregnancy ups the risk of fetal malformations andstillbirth. For the study, the researchers gauged the exactdegree of risk after looking at 633,449 women who gave birth inToronto between 1995 and 2002. Of the women, 21,823 werediagnosed with gestational diabetes.

Although the findings showed just 2% of the women whodid not develop gestational diabetes went on to develop type 2diabetes during the 9-year follow-up period, 19% of those withgestational diabetes did.

Diabetes, TB Link Found

A review of published studies indicates that patients with diabetesalso are at risk of developing tuberculosis (TB). As a riskfactor for active TB, the growing prevalence of diabetes mayimpact the global efforts to control TB, reported the researchersin PLoS Medicine (July 2008).For the study, the researchers found 13 studies including>1.7 million participants (n = 17,698 TB cases). Combining thedata from some of these studies, the researchers calculatedthat having diabetes raised the risk of active TB three-fold. Thisincrease suggests that diabetes may already be the cause of>10% of TB cases in India and China.

F A S T F A C T: More than 56 million Americanscurrently have prediabetes, according to the Centers for Disease Control and Prevention.