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The Diabetes Conundrum: What Physicians are Teaching You may be Killing You

June 21, 2005 | 59,537 views

Fact: Very little relationship exists between what a patient knows about diabetes and his or her control of its related cardiovascular risk factors and whether or not he or she ultimately succeeds or fails, indicated a study by Duke Clinical Research Institute.

Research found that improved disease knowledge alone does not lead to improved blood sugar control, cholesterol levels, weight management and mortality rates.

And, while education may be part of the puzzle, researchers noted there are likely other pressing health care delivery issues that must be addressed if a diabetic patient hopes to reduce their risks of dying from heart disease -- the main culprit of death among diabetic patients.

The Minute Role of Knowledge

Diabetic patients are twice as likely to suffer from acute coronary syndrome (ACS) than the general population; ACS can eventually lead to chest pain and possibly heart attack.

Considering the facts, researchers measured the progress of 200 diabetic patients who were treated for ACS. At enrollment, each patient took a 14-question standardized test that measured his or her knowledge on diabetes. Patients were then divided into two groups: high- or low-scoring.

Six months later, researchers linked how each of the groups scored with clinical measurements such as glycemic control, cholesterol levels, body mass index (BMI) and death. Data showed:

  • The only parallel between the two groups was that diabetes-related knowledge scores rose as the years of education increased.

  • In terms of mortality, the high-scoring group had a six-month mortality rate of 6.2 percent, compared to 9.7 percent for patients in the low-scoring group.

  • Moreover, 15.5 percent of the high-scoring group suffered from at least one heart attack, compared to 19.4 percent in the low-scoring group.

In light of the findings, researchers recognized the need to determine how to best assign scarce health care resources to reduce cardiovascular risk factors faced by diabetics.

American Journal of Cardiology June 1, 2005;95(11):1290-1294

Duke University Medical Center June 2, 2005

Guest Comment by Dr. Ron Rosedale:

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