April 15, 2013

Personalized Risk Assessment Aids Decisions

This is a generalized study about risk assessment. Diabetes is not among those discussed and this is a disappointment. With the fact that the American Association of Diabetes Educators (AADE) does not emphasize risk assessment for diabetes, and even the American Diabetes Association (ADA) does not have firm guidelines, this is a shame on these groups. There are many writers, bloggers, and other medical sources that write about risk assessment, but our professional organizations seem not to care. Stopping the diabetes epidemic should be a higher priority.

The ADA does have a program in place that people may use, but this is different from having a public policy or doctor recommended assessment procedure. In addition, the link here will take you to the diabetes risk test. This is not an assessment test, but a one-size-fits-all risk test. I admit I have seen poorly constructed risk tests, but this one does not properly evaluate your diabetes risk. The first panel only allows four age groups and stops at 69. Apparently, people over 69 are not at risk for developing diabetes. They may also figure that people over the age of 69 are not worth the effort of assessment. I have to call this age discrimination and add to this care discrimination. It is no wonder that the AADE does not have practice policies in place for the elderly.

Yes, the ADA does have several “stop diabetes” programs, but this is merely lip service. The ADA is not aggressively promoting diabetes risk assessment for doctors and does little to educate doctors. You say that they issue new guidelines every year. Yes, but how many doctors even read them, much less practice following them. If they really understood the ADA guidelines, then why do we encounter so much of what the next paragraph says?

Many of the sites having diabetes risk assessment tools available do a much more thorough task of assessment, but then bail on giving specific instructions about conferring with your doctor that is knowledgeable about diabetes. They do say to talk to your doctor. If your doctor is not current with the knowledge about diabetes, you may end up with a warning that “your blood sugar is above normal, watch what you eat” or something similar with no diagnosis of diabetes.

Always ask for your lab results so that you may see what the results of the tests state. If your fasting blood glucose or plasma blood glucose levels are above 125 mg/dl, then you may need to ask for the oral glucose tolerance test (OGTT). If your A1c level is above 6.4 this also applies. If the doctor balks, then I urge you to consider a change of doctors. The higher the results are above 125 mg/dl, the more urgent the need for a change of doctors. If your fasting or plasma blood glucose results are above 180 mg/dl, and your A1c is above 7.9%, then it is urgent that you find a doctor that will do the necessary testing for analysis. You need to know to be able to take actions to stop or prevent the development of any complications.

If the results are between 100 and 125 mg/dl, then you are at risk to develop diabetes. This is the range considered “prediabetes” and you should then learn what preventative measures you may take to prevent the onset of full diabetes. The A1c range is 5.7% to 6.4%. Most doctors seem to ignore this range, but there are preventive measures that are possible to take to prevent the onset of full diabetes.

This source is one of many risk assessments you may do yourself, but if you do not have diabetes now, take this seriously. If you are at risk, do your health a favor and schedule a doctor appointment with the specific instructions that you want to tested for diabetes.

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