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AACE Type 2 A1c Survey

Posted Jun 05 2009 5:06pm

Seems the American Association of Clinical Endocrinologists has released some horrifying statistics regarding Type 2’s in the USA and a purported lack of control in some 67% of these individuals, as shown by an inadequate A1c level.

To paraphrase the AACE media release, the combined results of 2003/2004 show that two of every three Type 2’s has an A1c above target (6.5%). 84% of those polled believed they were successfully managing their Diabetes, even though 61% didn’t know what the A1c is and half of those polled couldn’t remember their last test result.

It was stated that the average A1c was not calculated for this survey; whether or not that was because of a lack of substantial information is beyond me, but it seems (to me) a number that would’ve been important in this survey. (but of course, I don’t make those decisions)

While I was heartened by the fact that every article I’ve seen on this survey specifies Type 2 – rather than failing to specify the type and just lumping everyone as a Diabetic – I found myself wondering what questions this telephone study was comprised of. The bent of every article that I’ve read, even the release directly from the AACE’s website, seems to point the finger of blame for these statistics only at the Type 2’s surveyed.

So I’d like to know, were those polled asked questions about the quality of care that their Endo/GP’s had given them?? Did this survey critique the Healthcare Team as much as the Patient? I have heard so many Type 2’s repeat stories of slash-and-dash Diagnoses and Treatment plans. Newly diagnosed Type 2’s who don’t even know that they can self monitor their BG’s at home, who were never told what goals to set and strive for. Those who are fortunate enough to get instruction are told to self-monitor their BG’s on an infrequent basis; sometimes a couple of times a day, often a couple of times a week. Type 2’s who were initially Dx’ed by their GP’s and never referred to an Endocrinologist, let alone a multi-disciplinary team. And who were never told what an A1c is, let alone it’s importance.

And then there’s the financial side. From my understanding of the American Healthcare system, most that have supplemental health care insurance also have to have their physician pre-prescribe a specific amount of supplies per monthly basis (someone please correct or confirm this for me). Heck that’s if one is lucky enough to have supplemental insurance; if not you’re up Sh*t creek without a paddle! I’m not a Type 2, but I know that if I tested only a couple of times a day or a week my A1c would be catastrophic. Was the income level established in this survey, was there any correlation between those with higher A1c’s and lower income or lack of health insurance?

As far as I’ve been able to ascertain, the AACE didn’t publish the standard questions asked in this telephone assessment (at least I can’t find any mention of it, and I’ve searched). A campaign has been launched in which Type 2’s can take an oath to achieve better control; a list of 4 vague points that include taking meds as prescribed, setting goals and testing blood glucose levels, and speaking to his/her doctor about management plans. No mention of multidisciplinary teams that include CDE’s, Dieticians, Endocrinologists, etc. and no reference to Clinical Guidelines. But I suppose it's a place to start.

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