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Know Your Numbers, Outlive Your Diabetes, and other reading

Updated: 8/14/21 2:00 pmPublished: 4/30/07

Know Your Numbers, Outlive Your Diabetes

new book on diabetes gives patients a nice framework for their care

Some years ago, as part of a routine physical exam, my endocrinologist instructed me to provide a 24-hour urine sample. I don’t recall that he told me why, but I assumed it was important. Then a funny thing happened – no one told me the results. So after about two months, I called the office and asked one of the assistants.

To my surprise, we had a problem.

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Preventing Cardiovascular Disease in People with Diabetes

Cardiovascular disease (CVD), which includes heart attack and stroke, is the leading cause of death in the US today, accounting for nearly 40% of all deaths. Cardiologists have become increasingly skilled at treating people who’ve already had one heart attack or stroke in order to minimize their risk of a second one. This kind of treatment is called secondary prevention. Unfortunately, many patients don’t survive their first event, which is why it is best to treat individuals before they get their first. This is called primary prevention, and it’s particularly important for diabetic patients, who are at twice the risk of developing myocardial infarction (MI), or a heart attack, and stroke compared to the general population. Diabetes is itself a risk factor for CVD and up to 80% of type 2 diabetic patients eventually develop cardiovascular disease as a complication of diabetes.

In January, the American Heart Association and American Diabetes Association published a statement giving their joint recommendations for the primary prevention of CVD in patients with diabetes. Below we present an abbreviated version.

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Self-Monitoring of Blood Glucose (SMBG)

Intuition suggests that the more often people with diabetes check their blood sugars, the better their glycemic control will be. Frequent and careful blood glucose monitoring is unquestionably useful for people who take insulin, but is monitoring necessary for all patients? The American Association of Diabetes Educators (AADE) says: “yes.” Last winter the AADE published a position statement in The Diabetes Educator supporting the use of self-monitoring of blood glucose (SMBG) by all persons with diabetes, even the most ‘stable’ type 2 patients.

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