Strategies to Optimize the Management of High Risk African Americans with Diabetes, Renal Disease, and Cardiovascular Risk Factors
From the William E. Matory, Sr and Jr. M.D. Memorial Luncheon Symposium – Family Medicine Section held at the National Medical Association’s 2012 Scientific Assembly in New Orleans, Louisiana.
There is a substantial amount of knowledge and research on effective treatment strategies to prevent and/or delay diabetes and its complications. In spite of this knowledge, there exists a tremendous disparity between proven treatment regimens and the widespread use of these strategies. The American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists have provided medical guidelines for the intensive management of type 2 diabetes. Even with these guidelines, data from the Centers for Disease Control and Prevention suggest that less than 5% of patients with diabetes receive care that conforms to current guidelines. The majority of patients with diabetes receive their care from primary care physicians (PCPs). There have been a number of studies designed to improve the delivery of diabetes care at the level of the primary care provider. Several studies involving physician surveys, chart audits and review of administrative databases have shown that quality of diabetes care by PCPs is suboptimal. Lack of adherence to established clinical guidelines and failure to comply with quality measures is due to a number of factors, including physicians not remembering guideline recommendations, lack of time to carry out recommended procedures, lack of reimbursement, and lack of helpful technical and staff resources.
- The Office of Minority Health Diabetes and African Americans page, U.S. Department of Health and Human Services Web site. Diabetes and African Americans. http://minorityhealth. hhs.gov/templates/content.aspx?ID=3017. Accessed November 6, 2011.
- Centers for Disease Control and Prevention Web site. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf. Accessed November 6, 2011.
- Kaiser Commission on Medicaid and the Uninsured Web page, The Henry J. Kaiser Family Foundation Web page. Health Insurance Coverage and Access to Care Among African Americans
- Describe the clinical data to support the increased incidence of diabetes and renal disease in African Americans with type 2 diabetes.
- Describe the risk factors that contribute to worsening renal function in patients with type 2 diabetes: with a focus on the benefits of early detection and prevention.
- List the pros and cons of incretin based therapies in the management of high risk type 2 diabtes patients with renal impairment and cardiovascular disease.
Acknowledgement of Commercial Support:
This activity was supported in part by an educational grant from Novo Nordisk Pharmaceuticals.
The following faculty have indicated the following relationships with commercial interest.
- Anthony Cannon, M.D. – Speaker’s Bureau: Auxillium, Merck Shering Plough, Novo Nordisk
- James R. Gavin III, M.D., PhD, MPH – Consultant: Abbott Diabetes Care, Amarin Pharmaceuticals, Astra Zeneca, Bristol Myers Squibb, Novo Nordisk, LifeScan, Reta Pharmaceuticals
The following faculty have indicated no relevant relationships with commercial interest.
- Giden Adegbile, M.D.
- Kwabena Adubofour, M.D.
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