The American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE) today announced their recommendations for new diabetes screening and management guidelines. The group, comprised of world diabetes experts, urged more stringent treatment standards and a lower screening age for people at high-risk for this disease, particularly among ethnic populations.
"Diabetes has reached epidemic proportions in this country, affecting more than 16 million Americans," said Dr. Helena W. Rodbard, president of ACE. "It is crucial to empower patients to manage their disease more effectively thereby avoiding complications, such as kidney failure, blindness and amputations and premature heart attacks."
This first-ever ACE consensus conference gathered to review research from current international studies on diabetes in an effort to translate the data into practical guidelines that will result in more effective management of this disease. "Currently, diabetes guidelines in the United States are not consistent with world-wide standards," said Dr. Rhoda Cobin, president of AACE. "We need more aggressive, complete and cohesive standards."
In response to recent diabetes findings, the ACE Diabetes Mellitus Consensus Conference has made the following recommendations:
Age Of Diabetes Screening Lowered To Age 30
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The panel agreed that current guidelines for diabetes screening be reduced from 45 years of age to 30 for high-risk groups. Recent statistics from the Centers for Disease Control and Prevention (CDC) have shown that diabetes has increased 33 percent from 1990 to 1998, with an alarming increase (76 %) among people aged 30 to 39. In addition, diabetes occurs at a younger age in high-risk groups, which are developing the disease at alarming rates.
"Ethnic populations account for nearly half of all newly-diagnosed diabetes cases," said Dr. Jaime Davidson, endocrinologist at Medical City Dallas Hospital and co-chair of the conference. "In fact, one in four Latinos are diagnosed with diabetes by the age of 45 and African-American children as young as age five are exhibiting symptoms of insulin resistance - the beginning stage of diabetes. Because of these alarming statistics, ethnic populations need be screened at an earlier age," said Dr. Davidson.
A1C Blood Sugar Test Lowered To 6.5%
The panel has lowered the target for diabetes control to 6.5%, thereby bringing United States standards in concert with world-wide guidelines. A1C levels under 6% are normal for people without the disease. The A1C test is a simple blood test given to patients with diabetes to determine how well their blood sugar has been controlled over a three-month period.
"The conference reinforced that 'A1C' is the best test and term to use in determining how well a patient's diabetes is controlled over time," said Dr. Claresa Levetan, director of Diabetes Education at Medstar Clinical Research Center in Washington, DC, and conference co-chair. "It is critical that patients know their A1C level and their goals so that they are able to prevent diabetes-related complications," said Dr. Levetan.
Post-Prandial Blood Sugar Levels Lowered
The risk of diabetes comes from tissues that are exposed to abnormally high blood sugar levels both before and after meals. Therefore, the panel recommends lowering target levels of blood sugar to 110 before eating (pre-prandial) and to 140 after eating (two hour post-prandial). "Addressing the post-prandial levels is significant not only because it will reduce tissue damage for patients but also because it alerts them to a problem previously unaddressed in blood sugar monitoring," said Dr. Cobin.
Senator Susan M. Collins (D-ME), chair of the Senate Diabetes Caucus, addressed the conference noting, "I'm convinced that we're on the verge of substantial breakthroughs in the field of diabetes management and prevention." Sen. Collins pledged to continue her support of diabetes research funding.