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Where do we go from here?

Article Abstract:

The future of health care for patients with non-insulin dependent diabetes mellitus (NIDDM) involves education, of both patients and doctors, and the coordination of efforts within a health care team. A researcher highlighted the implications from recent studies on NIDDM that may shape the future of health care for patients with this disease. Doctors, patients, and the public need information about the seriousness of NIDDM and the importance of long-term comprehensive care. A recently formed national organization should be helpful in providing this information. Patients with NIDDM need an individually tailored treatment plan that addresses controlling blood sugar levels in light of the patient's overall health and allows for routine assessment of eye, nerve, and kidney disease. Managed care systems should realize that the cost of on-going comprehensive preventive care should be much less than the costs of future diabetic complications.

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Improving diabetes care in the primary health setting: the Indian Health Service experience

Article Abstract:

Providing primary health care providers with updated guidelines and feedback can improve the health of patients with non-insulin dependent diabetes mellitus (NIDDM). A team of health professionals routinely sampled and reviewed medical records of patients with NIDDM attending rural Native American health clinics and provided the clinics with updated guidelines and feedback on patient statistics. The pneumonia vaccination rate for these patients increased from 24% to 59% while the percentage who got annual foot examinations increased from 44% to 57% in 7 years. The percentage of patients with high blood pressure decreased from 36% to 25% in one year but rebounded to 33% the following year when they provided less feedback. About one third of the patients had near-normal blood sugar levels while 9% had high blood sugar levels based on a recently described but as yet standardized classification system.

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Metabolic and cardiovascular effects of carvedilol and atenolol in non-insulin-dependent diabetes mellitus and hypertension: a randomized, controlled trial

Article Abstract:

Carvedilol appears to be a potentially effective blood pressure medication in patients with diabetes. Markers of glucose and fat metabolism, blood pressure measurements, and lower left heart mass measurements were analyzed in 45 diabetic patients with high blood pressure treated with either carvedilol or atenolol. Patients treated with either medication experienced similar blood pressure and heart mass decreases. However, patients treated with carvedilol had lower glucose, insulin, and triglyceride levels, higher high-density cholesterol levels, and greater glucose and fat metabolism than those treated with atenolol.

Evaluation, Hypertension, Drug therapy, Antihypertensive drugs, Antihypertensive agents, Atenolol

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