While not really a game plan at all,
there are some features that this site may bring to peoples
attention. Probably the only reason I found this site is an article
in Medscape. After researching on the American Association of
Clinical Endocrinologists (AACE) and the American College of
Endocrinology (ACE) websites, I did not find a link to
BloodSugarBasics.com http://bloodsugarbasics.com/. Is this intentional? Maybe. Both websites do
little to promote what they hype in articles or interviews, so it is
small wonder that little is accomplished in bringing visitors to
their sites.
Even my own endocrinologists do not
promote this during office visits or include information about it in
handouts. Why am I writing about this? Someone needs to promote
what the professionals are seemingly incapable of doing. I think the
person that made this comment – quote - “Unfortunately,
like the AAFP, the AMA and ACC have also let us down. The societies
today exist for their own purposes and not for the benefit of
members. The AMA owns the CPT code system and makes more money from
this behemoth than from member dues. The ACC is enthusiastically
offering "products" (read $$$) to "help" doctors
meet their performance goals.
It is beyond
time for new professional societies to emerge that actually advocate
for physicians involved directly in patient care. Perhaps one big
"Society for Patient Care Physicians" that could involve
everyone who actually sees patients every day, rather than the
academic guideline and rule-writing "doctors" who dominate
societies today.” - Unquote.
I think the comment is on target and
needs to be done so that doctors that care for and about patients
could have a format to get information to patients in terms they
understand and this could be promoted for patients. With the
Internet of today, what could be of value to patients is often lost
in the dogma of the medical organizations. Most could have on their
home page a link to patient information and then links on the patient
page for more pages of valuable information. This information could
then be reliable information that can be used for the benefit of
patients and used by patients.
Even the website for approved Internet websites on the AACE website no longer has a direct link to it on the home page. Plus, they are not adding anymore approved sites. They have fulfilled their promise so-to-speak, and now want to leave it alone. For the two sites of the AACE and ACE, there is so much information that could be included as part of their websites. However, at most, the information is limited for patients and not really informative for new patients that may be searching these sites for reliable information.
On the same site is a tab named “The
ABCs of Diabetes Management.” This did not surprise me as they are
A1c, blood pressure, and cholesterol. Surprise, no mention is made
about statins. Blood pressure goals are different than recommended
by the American Heart Association, but not significantly higher.
From the way the material is presented, the emphasis seems very much
on the HbA1c as the measurement for how well the goals are being
accomplished not any individual blood glucose tests. At least the
A1c goal is 6.5%, but then they say that maybe the goal will need to
be higher. No mention is made about individuals that want to strive
for lower A1cs or if they will even allow for this.
Then they use four topics to help in
achieving the ABCs. They include healthy eating, getting more
active, taking your medication, and tracking your ABC goals. I was
totally surprised at the healthy eating. They rightly say to limit
refined foods and eat vegetable and some fruits. Maybe a little
heavy on the fruits, but no mention of whole grains. The limited
discussion on getting more active was not bad, but the discussion
missed a lot of physical activity. Taking your medication(s) did not
discuss any particular medication(s), but the suggestion is there.
The concern for hypoglycemia is present and that is a plus. Tracking
your ABC goals missed more than it covered. It talks about tracking
your blood glucose levels, but does not give any meaning to why track
and what to be looking for in meaning. To me, it sounds more like
the reason is for the doctor than looking for reasons to the daily
numbers.
In the medscape interview, Farhad
Zangeneh, MD, FACP, FACE did a good thing in answer to a question
about why not use the more effective treatment of bariatric surgery
for all obese type 2 patients than have them struggle with lifestyle
changes to achieve treatment goals. I will quote his answer - “Not
all patients with type 2 diabetes are candidates for bariatric or
metabolic surgery, and no matter how much weight is initially lost,
there is always weight rebound. There are no easy answers and no
shortcuts in the management of diabetes. Even if patients are
candidates for bariatric surgery, their psychology — mindset and
eating behavior — has to change before their anatomy. There is
also growing evidence that patients who undergo gastric bypass
surgery are prone to hypoglycemia. For the majority of patients with
diabetes, management still boils down to healthy eating, physical
activity, and pharmacological medical management.”
As for the goals of “The Game Plan,”
most of the information is on a need to be done basis and not
education about diabetes and the reasons for doing what is all but
demanded that patients do. Some information is there and for some
patients that function in this manner, it may be of value.
What I think is that few people are
going to find this site without a direct link to it from the AACE
main page or even a link from the ACE page. Few patients with type 2
diabetes ever read the articles from the medscape dot com site and I
have not seen any other mention of the site elsewhere. Granted I do
not read every website, but I think Merck was sold an idea with no
solid intention of promoting the website by AACE. Some people will
find the website from search engine use, but that will be a small
number. Great idea, but no support of the site by AACE.
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