1 in 5 Younger Diabetics Lacks Good Medical Care, Study Says

CDC team found 19 percent hadn't seen a doctor within last 6 months

By E.J. Mundell

Tuesday, February 3, 2015

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Diabetes

TUESDAY, Feb. 3, 2015 (HealthDay News) -- One in every five young American adults with diabetes hasn't seen a doctor in the past 6 months, a new government report indicates.

The study, from researchers at the U.S. Centers for Disease Control and Prevention, also found that those aged 18 to 39 with diabetes were much less likely than older patients to have gotten their blood pressure or cholesterol checked in the previous year.

"Ongoing medical care is recommended for persons of any age who have diabetes in order to manage levels of glucose [blood sugar], obtain preventive care services and treat diabetes-related complications," wrote the team, led by Maria Villarroel of the CDC's National Center for Health Statistics (NCHS).

According to the agency, almost one in every 10 American adults (9 percent) has some form of diabetes. Most cases will be type 2, which is often linked to obesity and comprises about 95 percent of diabetes cases. The rest are type 1 disease, which often arises in childhood and occurs when the pancreas cannot produce enough insulin.

To manage diabetes, the American Diabetes Association currently recommends that people visit a doctor every 6 months to help manage fluctuating blood sugar levels. For those with unstable blood sugar, the recommendation is to meet with a doctor more frequently.

The new report looked at 2013 government health data on nearly 3,600 adults with diabetes. It found that adherence to care recommendations rose with age: 81 percent of people aged 18 to 39 had seen a health care professional over the past six months, compared to about 89 percent of those aged 40 to 64, and more than 93 percent of those aged 65 or older.

Medications such as insulin and other drugs can help manage diabetes. Again, the CDC study found that the number of patients taking a diabetes medication rose with age -- from about 71 percent of those aged 18 to 39, to 86.5 percent of those over 65.

"Retinal [eye] damage and nerve damage to the feet are diabetes-related complications that contribute to major [illness] and disability among adults with diabetes," the CDC team also noted. Twice-a-year doctor exams are recommended to spot such problems. But the research showed that young patients were much less likely to have consulted with either an eye or foot doctor over the past year, compared to older patients.

One expert noted that those kinds of complications are what makes diabetes so deadly in the long run.

"All of these complications are the main reasons why diabetics are more likely to get heart attacks, strokes, amputations, blindness and dialysis, just to name a few," said Dr. Maria Pena, director of the Center for Weight Management at North Shore-LIJ's Syosset Hospital, in Syosset, N.Y. "Development of these dreaded complications is what leads to impaired quality of life and life expectancy, as well as adding to our health system's financial burden."

But regular doctors' visits could bring big health payoffs for young people with diabetes, Villarroel's team said. Increasing rates of compliance with recommended care when a patient is still young "may favorably impact health outcomes and quality of life in later years," the researchers wrote.

Another expert said that, while more needs to be done, more younger patients with diabetes are getting care than in decades past.

However, Dr. Gerald Bernstein added that the new statistics only look at the "tip of the iceberg," because "underneath are millions of people with pre-diabetes, most of whom are not diagnosed."

Bernstein directs the diabetes management program at Mount Sinai Beth Israel Hospital in New York City. "During the pre-diabetic phase there is festering deterioration, especially the cardiovascular system, so that by the time the diagnosis of clinical diabetes is made, many already have impairment that was preventable," he said.

"If we don't prevent the diseases, there will be serious medical and economic consequences," he said.

The study was published online Feb. 3 in the NCHS Data Brief.

SOURCES: Maria Pena, M.D., director, Center for Weight Management, North Shore-LIJ's Syosset Hospital, Syosset, N.Y.; Gerald Bernstein, M.D., director, diabetes management program, Mount Sinai Beth Israel Hospital, New York City; NCHS Data Brief, Feb. 3, 2015, online

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