Diabetes: Monitoring and counseling patients with prediabetes and type 2 diabetes

Dang, Devra K.
November 2011
Drug Topics;Nov2011, Vol. 155 Issue 11, p51
Trade Publication
Approximately 26 million Americans are currently diagnosed with diabetes, and another 79 million have been diagnosed with pre-diabetes, at a total cost to the economy of more than $175 billion per year. The prevalence of type 2 diabetes has been rising in parallel with the rates of obesity, and these trends highlight the growing importance of early detection of individuals with risk factors for diabetes such as obesity, physical inactivity, hypertension, cardiovascular disease, and elevated blood serum levels of glucose and lipids. Complications of diabetes are numerous and severe: In addition to sensory and autonomic neuropathy they include diabetic retinopathy and diabetic nephropathy -- the leading causes of blindness and kidney failure. While first-line therapy emphasizes nutrition therapy, exercise, and weight loss, medical interventions have also proven effective. These include medications to control hyperglycemia, dyslipidemia, and hypertension, as well as bariatric surgery. The pharmacist is in a unique position to play a critical role in diabetes care, by counseling patients in self-monitoring techniques, by helping to ensure that patients adhere to their prescribed medication regimens, by educating patients about adverse drug reactions, and by playing a central role in medication therapy management. The Asheville Project and Diabetes Ten-City Challenge demonstrated that a multimodal approach -- including counseling, self-monitoring, lifestyle changes, and appropriate medication -- can significantly reduce the risk of diabetes and the costs associated with both its treatment and its economic effects.


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