Preventing diabetes-related morbidity and mortality in the primary care setting

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Diabetes is the leading cause of blindness, end-stage renal failure, non-traumatic limb amputations, and cardiovascular morbidity and mortality. The vast majority of patients with diabetes receive routine care from primary care providers who are not endocrinologists. Primary care providers, including internists, family practice physicians, and physician extenders with advanced skills, face the important task of implementing standards of care recommendations for persons with diabetes. These recommendations draw upon an emerging body of compelling . evidence regarding the prevention and management diabetes and its complications. The challenge of diabetes must be tackled on three fronts: Primary prevention, secondary prevention (of diabetes complications), and tertiary prevention (of morbidity and mortality from established complications). There is now abundant evidence that type 2 diabetes, which accounts for greater than 90% of diabetes world-wide, is preventable. Moreover, the complications of diabetes are preventable by a policy of tight glycemic control and comprehensive risk reduction. Even after complications have set in, intensive glucose control dramatically reduces the risk of progression of complications. The challenge, therefore, is the identification of strategies that enable translation of existing scientific data to pragmatic benefits. This article proposes 10 strategies for preventing or reducing diabetes-related morbidity and mortality at the primary care level. These strategies include provider education; patient empowerment through promotion of lifestyle and self-care practices; surveillance for microvascular complications; cardiovascular risk reduction; efficient use of medications; goal setting; and stratification of patients and triaging of those with poor glycemic control for more intensive management.

Original languageEnglish (US)
Pages (from-to)549-560
Number of pages12
JournalJournal of the National Medical Association
Volume94
Issue number7
StatePublished - Jul 1 2002

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Diabetes Complications
Primary Health Care
Risk Reduction Behavior
Morbidity
Mortality
Tertiary Prevention
Patient Participation
Physician Assistants
Family Practice
Family Physicians
Blindness
Primary Prevention
Standard of Care
Self Care
Secondary Prevention
Amputation
Type 2 Diabetes Mellitus
Chronic Kidney Failure
Life Style
Extremities

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Preventing diabetes-related morbidity and mortality in the primary care setting. / Dagogo-Jack, Samuel.

In: Journal of the National Medical Association, Vol. 94, No. 7, 01.07.2002, p. 549-560.

Research output: Contribution to journalArticle

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