Diabetes Pro Quarterly - Summer 2013 - (Page 10)

PROFESSIONAL EDUCATION News From the 73rd Scientific Sessions continued from page 7 the level of LDL cholesterol (the so-called bad cholesterol) compared to the group that received diabetes support and education. The support and education group lost 0.7 percent initially and 3.5 percent at the end of the intervention. However, the intensive lifestyle intervention group did experience other benefits when compared to those in the comparison group, including reducing the risk of kidney disease, self-reported retinopathy, and depressive symptoms. Other benefits included an improved physical quality of life, and reduced annual hospitalization rates and costs. Lifestyle intervention also produced greater reductions in HbA1c, and greater initial improvements in fitness and all CVD risk factors except LDL cholesterol. Another study looked at whether having health care providers tell patients to make lifestyle changes would get them to do so. “We wanted to see how effective a lifestyle change program would be for patients in a national health care system,” said Sandra L. Jackson, MPH, a PhD candidate in nutrition and health sciences at Emory University in Atlanta, whose dissertation research focuses on this question. “In order to achieve wide-scale results in reducing the prevalence of diabetes in this country, we need to get to patients who are at risk. One way of doing this is through their health care providers, and such a strategy—if found to be effective—could be replicated across many health care systems.” Jackson analyzed the records of 400,000 patients in a VA program known as MOVE! (Managing Obesity and Overweight in Veterans Everywhere). Patients were directed to the program by their health care providers during routine medical visits. Unlike patients in the DPP study, and other lifestyle intervention programs based on that work, these patients were not volunteers and therefore potentially not as motivated to make changes. Among all participants, the researchers found weight loss of 1.3 percent of body weight, on average, was maintained over a three-year period. Among those who enrolled in eight or more sessions over six months (a more active group of 10 participants), they found substantially greater weight loss of 2.7 percent of body weight (5.4 pounds in a person weighing 200 pounds). They also found that those veterans who had already been diagnosed with diabetes were more likely to become active participants in the program than those who did not have diabetes at the start of the program. Additionally, those who lost more weight at six months were less likely to develop diabetes over three years: preliminary results revealed that for every additional pound of weight lost, the risk for developing type 2 diabetes dropped by about 1 percent, adjusted for baseline BMI, age, and gender. Other Highlights This year’s meeting also featured a joint symposium between the American Diabetes Association and the Juvenile Diabetes Research Foundation (JDRF), at which researchers described new tools that have been developed to help determine when type 1 diabetes begins to develop, and how to accurately predict who is at highest risk for this disease, opening possibilities for earlier intervention and potentially greater preservation of beta cell function. They also discussed ongoing research to identify the triggers for type 1 diabetes, along with some of the challenges they face in collecting data on the prevalence of type 1 diabetes in low-income countries. The symposium also drew attention to the difficulty people in low-income countries often have accessing insulin and other diabetes supplies. ADA Presidents’ Addresses John E. Anderson, MD, President, Medicine & Science, addressed the problem created by the declining number of physicians training to care for people with diabetes, contrasted with the rising prevalence of this disease. Noting that the primary care community delivers approximately 90 percent of the care for individuals with diabetes in this country, and that the percentage of internal medicine residents who are training in general medicine is declining, Anderson wondered how physicians who are already overwhelmed by their patient loads will be able to meet the demand. “Are we, WE—all of us in this room— ready to meet the challenge?” he asked. Meanwhile, he noted, the need for family practitioners is increasingly being filled by doctors from other countries. “These international medical graduates do a very good job of taking care of patients, yet they are being pulled from areas where they are needed most: developing countries with an even greater burden of diabetes than the United States.” Anderson blamed the high cost of American medical schools and the push to enter subspecialties. The solution, he said, could lie in the growing number of nurse practitioners and physicians assistants, who have traditionally gravitated towards primary care. But, he warned, many are taking jobs in hospitals and clinics providing short-term care, rather than in John E. Anderson, MD, President, Medicine & Science. settings where they could help patients with diabetes in a more personalized, long-term way. Ideally, people with diabetes would have their care managed by endocrinologists, but these, too, are in short supply, Anderson lamented. “If we are to meet the daunting challenges of this diabetes epidemic, much will need to change, starting with graduate medical education reform,” he said. He added that greater funding for research as well as training is needed, and encouraged his peers to take on a greater advocacy role. Anderson ended his talk with the announcement that the Association will soon be funding innovative research through a new program known as the

Table of Contents for the Digital Edition of Diabetes Pro Quarterly - Summer 2013

Diabetes Pro Quarterly - Summer 2013
In This Issue
Arizona Safe at School Victory
6th Disparities Partnership Forum
News From the 73rd Scientific Sessions
July 2013 American Diabetes Association Award Recipients

Diabetes Pro Quarterly - Summer 2013