Medical care for patients with diabetes: epidemiologic aspects

Article Abstract:

Changes in patient habits, patient education, and health care practices will likely occur if proposed changes in the management of patients with diabetes proceed. Proposed changes include closely monitoring and aggressively managing blood sugar levels in patients with diabetes. A researcher highlighted current patient self-care habits and professional intervention patterns as documented by a survey of 2,405 persons with diabetes. About one-third of the respondents make fewer than four visits to their doctor in a year. Of the respondents taking insulin, only 40% of those with insulin-dependent-diabetes and 26% of those with non-insulin-dependent diabetes reported testing their blood sugar levels daily. Only half of the respondents reported having a dilated eye examination during the previous year. Most respondents taking insulin (85%) check their feet weekly. Ninety percent of the respondents acknowledged the importance of diet in controlling their disease. However, only 64% admitted following a diabetic diet.

Behavior, Diabetics

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Effects of intensive diabetes therapy on neuropsychological function in adults in the Diabetes Control and Complications Trial

Article Abstract:

Multiple-dose insulin treatment and severe low-blood sugar episodes do not seem to affect brain and motor function in otherwise healthy adolescents and young adults with insulin dependent diabetes mellitus (IDDM). Severe low-blood sugar episodes include coma or seizure. Doctors treated 1,441 patients with IDDM aged 13 to 39 years with either 3 or more doses of insulin per day or one or two doses per day. These patients reported any severe low-blood sugar episodes and completed intelligence, psychological, and basic motor function tests at the beginning of the study, and at two, five, seven, and nine years thereafter. The results of the intelligence and psychological tests taken at two and five years were similar between the two treatment groups. Motor function slightly improved in the group taking multiple-dose insulin. There was no association between the number of severe low-blood sugar episodes and any test results.

Evaluation, Neuropsychological tests

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Diabetes in a managed care system

Article Abstract:

Cooperation between diabetes research teams and managed health care organizations may lead to better health care delivery to patients with diabetes. A researcher outlined the managed care strategies that could limit adequate care delivery to diabetic patients and suggested ways to improve this care delivery within the managed care system. The overall goal of managed care systems to control cost can limit coverage of routine monitoring devices and limit access to appropriate specialists, hospital care, and insurance coverage. However, the structure of managed care systems may encourage more preventive care. Designing research studies that address the cost-effectiveness of diabetes care may encourage better cooperation with managed care systems.

Services, Managed care plans (Medical care)

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