tailieunhanh - Diagnosis and Management of Pituitary Disorders - part 6

Giới thiệu phổ biến và Chi phí của bệnh tiểu đường Chứng minh lợi ích của trị liệu cho nhân dân với bệnh tiểu đường Hướng dẫn thực hành lâm sàng cho Thành tựu quản lý bệnh tiểu đường của Hướng dẫn khuyến nghị Tài liệu tham khảo Kết luận | 15 Adherence to Practice Guidelines for People with Diabetes Mellitus Mandell Colón Scanlan and Lawrence Blonde Contents Introduction Prevalence and Cost of Diabetes Demonstrated Benefits of THERApy for People with Diabetes Clinical Practice Guidelines for Diabetes Management Achievement of Guideline Recommendations Conclusions References Key Words Adherence diabetes guidelines insulin dyslipidemia hypertension. INTRODUCTION The incidence and prevalence of diabetes have increased to epidemic proportions. Practice guidelines largely supported by randomized controlled clinical trials provide therapeutic targets that if met would dramatically reduce the morbidity and mortality associated with diabetes. Yet adherence by both patients and their health care professionals to these guidelines and to specific therapeutic recommendations designed to achieve guideline targets remains much less than optimal. This chapter will discuss the level of adherence to guidelines and speculate on both causes and potential remedies for suboptimal adherence. PREVALENCE AND COST OF DIABETES The Centers for Disease Control and Prevention CDC estimates that in 2005 the total prevalence of diabetes in the US was million people or 7 of the population. This was an increase from the 2002 estimate of million or of the population. Nearly 10 of adults and over 20 of those 60 year of age or older have diabetes and there has been a marked increase in the incidence and prevalence of type 2 diabetes among children and adolescents 1 . Both acute and chronic complications of diabetes have enormous personal and societal economic costs. Diabetes is the number one cause of adult blindness and end stage kidney disease in this country. Diabetes increases the risk for heart disease and stroke by 2- to 4-fold and is associated with many abnormalities of the nervous system collectively termed diabetic neuropathy. As a result diabetes was estimated to account for 11 of total healthcare costs in the

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