Diabetes Series: Intro

Diabetes mellitus type 2 is an alarmingly artful monstrosity, luring victims into a false sense of security as it unmercifully ravages the body. Insidious in nature, diabetes convinces people it is benign, after all, everyone knows someone with it, if it’s so ubiquitous, how dangerous can it really be? As a result, oscitant patients continue on with their lives, unaware of the horror raging through their veins.

Despite the generalized lax perception, the reality of diabetes is terrifying. The chronic disease raises the risk for depression, sleep problems, erectile dysfunction, dental issues, and infections. Reports indicate that it more than doubles the risk of hearing loss; is the leading cause of blindness, amputations, and kidney failure; and can triple the risk of heart attack and stroke.¹  It also wreaks havoc on the gastrointestinal system, causing vomit-inducing gastroparesis and loss of bowel control. Diabetes is closely associated with non-alcoholic fatty liver disease, which can progress to liver failure and cancer. Taking everything into account, it is not surprising diabetes is in the top ten of leading causes of death in the US.

Complications brought on by sedentary lifestyles, Western diets, and genetics are compounded by the sheer number of patients increasingly developing diabetes. According to the American Diabetes Association, in 2012, 29.1 million Americans, or 9.3% of the population has the disease with 1.4 million being diagnosed every year.²  Uncontrolled diabetes can be incapacitating, leading to $69 billion in reduced productivity as patients become home-bound.³  The staggering total cost of diagnosed diabetes in 2012 was $245 billion.4

Furthermore, diabetes coincides with the rise of socioeconomic inequality and its attendant perpetuation of poverty and deteriorating education. Many patients struggle to afford frequent doctor visits, numerous medications, or healthy food options. Ability to cope with diabetes becomes even more difficult when factoring in low health literacy. The seemingly all-encompassing complexities make it a management nightmare.

As a primary care physician, there is no escaping the medical juggernaut of diabetes. PCPs treat at least 90% of diabetic patients, and yet, data demonstrates that only 57% of diabetics achieve a target goal of hemoglobin A1c levels less than 7%, and only 12-13% achieve recommended target goals for hemoglobin A1c, blood pressure, and serum lipid level.5  These dismal numbers are despite a dizzying array of new drugs and treatment algorithms.

The breadth and depth of knowledge necessary to understand, diagnose, treat, prevent, and explain diabetes is harrowing. The goal of the following series is to begin exploring topics concerning this healthcare miscreant in hopes of elucidating clinical insight on how to best serve patients.

Endnotes

  1. Parker-Pope T. Diabetes: Underrated, Insidious and Deadly. The New York Times. http://www.nytimes.com/2008/07/01/health/01well.html. Published July 1, 2008. Accessed February 26, 2017.
  2. Statistics About Diabetes. American Diabetes Association . http://www.diabetes.org/diabetes-basics/statistics/?referrer=https://www.google.com/. Published December 12, 2016. Accessed February 26, 2017.
  3. Statistics About Diabetes. American Diabetes Association . http://www.diabetes.org/diabetes-basics/statistics/?referrer=https://www.google.com/. Published December 12, 2016. Accessed February 26, 2017.
  4. Statistics About Diabetes. American Diabetes Association . http://www.diabetes.org/diabetes-basics/statistics/?referrer=https://www.google.com/. Published December 12, 2016. Accessed February 26, 2017.
  5. Davidson JA. The Increasing Role of Primary Care Physicians in Caring for Patients With Type 2 Diabetes Mellitus. Mayo Clinic Proceedings . 2010;85(12):S3-S4. doi:10.4065/mcp.2010.0466.
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