January 14, 2011

Calling for More Testing for Diabetes

A lot more needs to be done. It seems many educational institutions are jumping on the band wagon of encouraging more testing for diabetes. But calling for more testing is not getting the job done. Unless this call is turned into action, nothing will change. And this is all to often the case. Calls go out, but no one follows through to see that doctors are doing this and often the insurance companies are discouraging them.

If these institutions would encourage their medical schools to spread the word and talk to their graduates, more good might happen. What might assist if pressure on the medical insurance industry to request doctors do this to remain on the approved list. Doubt insurance would consider, but it could save them big bucks in the long term.

In addition they would actually be doing some excellent preventative medicine and developing customer relations. What is it going to take to get everyone on board and taking action. I suspect it is a task for people in a position to call investigations and enact legislation that might force this stalemate.

Yes, why even have elected officials if they cannot act on behalf of their constituents. The Alzheimers Association has a national plan. What can't the American Diabetes Association have a national plan. Probably because it is not part of their 2011 priorities.

Many of the Type 1 people are talking about talking to their elected officials and are doing this, but it is not even on the agenda for the ADA. This is another reason those of us with Type 2 need a new organization that will advocate for 90 to 95 percent of the people with diabetes.

Using the HbA1c test as a screening test is somewhat practical, but both tests should be preformed. If getting this started requires giving up one test, then so be it. In the January 2011 issue of the American Journal of Preventive Medicine, a study reports that the A1c test can be administered in the physician's office and will identify pre-diabetes.

If they can identify more individuals with pre-diabetes in the physicians office, it will give an opportunity to stop the progression of the disease and possibly delay diabetes for many years. This would be a win for the people in terms of healthcare and even a win for the medical insurance industry with less expenses.

If you are considering being tested, learn the signs for risk for diabetes. They are high blood pressure or heart disease, being overweight or obese, or a family history of diabetes, over the age of 45, and are a woman with a past gestational diabetes, get yourself tested to determine if you have prediabetes. If you are diagnosed as having pre-diabetes, loosing as little as 10 to 15 pounds through exercise and diet will cut your chances in half of developing diabetes. This will improve your health dramatically if you treat it as serious and keep working at it.

Read the article on the study here and good luck. For those of us already with diabetes, if you can work this in with a friend that shows the above probabilities, do it politely and explain how it can help.

This article appeared on January 13, 2011. It is not a total shock that they say that nearly one-half of the people with Type 2 diabetes do not manage it. From the persons I know locally, I thought the percentage would have been nearer 60 percent.

Don't get me wrong, nearly 50 percent is horrible, and coming from the Centers for Disease Control, I can trust these numbers a lot more that my own observations. This public health initiative is between the doctors of endocrinology and two large pharmacological companies.

This may be a lofty project, but at least some of the people in a position to do so are involved. Now the problem will be if we can get them behind the screening for diabetes and pre-diabetes.

January 11, 2011

ADA Has Legislative Priorities?

Well, on January 6, 2011, the American Diabetes Association finally issued their 2011 legislative priorities. While reasonable, I see nothing innovative or challenging in their agenda. It is good to know that they continue to back federal funding for several established government agencies.

Since they don't wish to be specific in their priorities, this should not be a challenge since most of the Federal funding of this will probably be funded, but to a lesser degree than previously with the cutbacks necessary to rein in our bloated budget.  I sincerely hope that this has some success.

Now to take the remaining list of priorities and my comments.

Health Reform Defense & Implementation – focus on access to quality, affordable coverage that provide people with, and at risk for, diabetes the tools necessary to manage diabetes and prevent its onset and complications
I have to wonder why this means defending the Affordable Care Act (ACA) which congress is under mandate from the people to repeal. Plus if they are participating in the legal defense, I think this would be wrong on so many levels. We do need affordable coverage and many people do need the tools to manage diabetes to prevent its onset and complications. This seems such a mild statement, that one must wonder what they expect to accomplish.  ADA's track record is not even a fair rating in the past.

Prevention – focus on primary prevention of type 2 diabetes centered on prediabetes, physical activity and nutrition
If they follow through with this, this could be great. Again they fail to mention any specifics and this should always be a top priority, especially the way they expect the number of people with diabetes to increase.

Eliminating Disparities in Diabetes Prevention and Access to Care Act to address racial and ethnic disparities
This is an excellent goal, but hopefully will encompass financial disparities. Otherwise this priority will fail.

Gestational Diabetes Act to expand diagnosis, data collection and treatment
This does reflect the major change in policy and definition for gestational diabetes in the 2011 Care Guide. For this issue alone they get my praise for something positive.

Diabetes Screening and Medicaid Savings Act to provide screening and diabetes care under Medicaid
A good priority, but lacks support in encouraging the insurance industry and Medicare to provide necessary screening from children to the elderly.

Stem Cell Research
This is too broad a priority and should be limited to research for diabetes applications only.

Health Entitlement Programs including Medicare and Medicaid
Should include all, meaning not only Medicare and Medicaid, but the medical insurance industry as well.

Discrimination Issues
Time for ADA to act accordingly and end their own discrimination.  The one area they listed is worthy, but does not address ADA's own discrimination.

Bills Related to Complications and Comorbidities of Diabetes
This is very general as it needs to be. What legislation will be introduced remains a mystery until introduction.

These are at best broad priorities for an organization that should also have some specific goals and priorities. I would hopefully think they could publish some specific goals and priorities.

The listed or published priorities are in and of themselves very discriminatory. No where is any mention made of doing anything for Type 1 diabetes.  Only Type 2 is given a mention. It is small wonder that the number one complaint against the ADA is their discrimination against Type 1, yet at every chance they get they will take credit for something the JDRF accomplishes. 

I agree with those that want to hold ADA's feet to the fire for their lack of attention to Type1 priorities. Even the monogenic diabetes classifications get no mention in their priorities. While Type 2 is about 95 percent of all diabetes, does this mean that the others deserve no mention. I don't think so!  I also will not accept that the word diabetes means all types when one type, Type 2 is singled out.

Read their priorities here, a slightly expanded version here, and if interested a list of the officers here.