Guidelines Urge More Aggressive Diabetes Care

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Guidelines Urge More Aggressive Diabetes Care

By Gearon

WASHINGTON (Reuters Health) - New diabetes guidelines released Tuesday

recommend a significantly lower screening age for people at high risk of

the disease and call for more aggressive treatment.

In diabetes, the body does not produce enough insulin, or cannot respond

to the hormone, which helps the body to process sugar properly. Poorly

controlled diabetes results in high blood sugar levels and damage to the

blood vessels, which can eventually lead to heart disease, vision loss,

nerve damage and other complications.

``We are making diagnoses 6.5 to 10 years too late,=B4=B4 said Dr.

son, an endocrinologist at Medical City Dallas Hospital and

co-chair of the American College of Endocrinology=B4s (ACE) Consensus

Conference on Guidelines for Glycemic Control. The ACE created the

guidelines along with the American Association of Clinical

Endocrinologists (AACE).

Under current guidelines, half of people diagnosed with diabetes already

are suffering from complications of the disease, son noted.

To help detect diabetes earlier and improve treatment, the new

guidelines recommend that people in high-risk groups be screened for

diabetes at age 30, rather than at age 45.

Those at high risk include people with a family history of the disease,

people at risk for heart disease, overweight individuals, those leading

sedentary lifestyles and members of certain ethnic groups, including

Hispanics, African Americans and Asian Americans.

Others at risk include people with high levels of blood fats called

triglycerides, as well as those with low levels of HDL, or ``good,=B4=B4

cholesterol. Women who have developed diabetes during pregnancy and

those who have delivered babies weighing more than 9 pounds are also at

risk.

The consensus panel also recommended lowering the target blood sugar

level to 110 before a meal and to 140 after a meal.

``Excellent, meticulous diabetes control is necessary, is mandated and

is required to prevent patient complications,=B4=B4 Dr. Rhoda Cobin,

AACE president, told Reuters Health.

The guidelines also lower the target level for the hemoglobin A1C test,

which measures long-term blood sugar control, to 6.5%, bringing US

standards in line with current worldwide guidelines. Previous standards

had suggested a target level of 7%, but delayed action until a patient

had an 8% reading, which committee members said was confusing.

``A reduction in A1C means a better future for all patients with

diabetes,=B4=B4 son said. For each 1% reduction in A1C, he

explained, there is a 25% cut in diabetes-related complications.

And the hemoglobin A1c test should be renamed ``A1C,=B4=B4 the

guidelines state, so that people can more easily identify the test with

sound diabetes control.

``For the first time, we have clear, concise guidelines so patients with

diabetes and their physicians can know how to treat the disease and

prevent deadly complications of diabetes,=B4=B4 Dr. Claresa Levetan,

director of diabetes education at Medstar Clinical Research Center in

Washington, DC, said.