Not A Game Plan for Type 2 Diabetes

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While not really a game plan at all,there are some features that this site may bring to peoplesattention. Probably the only reason I found this site is an articlein Medscape. After researching on the American Association ofClinical Endocrinologists (AACE) and the American College ofEndocrinology (ACE) websites, I did not find a link toBloodSugarBasics.comhttp://bloodsugarbasics.com/. Is this intentional? Maybe. Both websites dolittle to promote what they hype in articles or interviews, so it issmall wonder that little is accomplished in bringing visitors totheir sites.
Even my own endocrinologists do notpromote this during office visits or include information about it inhandouts. Why am I writing about this? Someone needs to promotewhat the professionals are seemingly incapable of doing. I think theperson that made this comment – quote - “Unfortunately,like the AAFP, the AMA and ACC have also let us down. The societiestoday exist for their own purposes and not for the benefit ofmembers. The AMA owns the CPT code system and makes more money fromthis behemoth than from member dues. The ACC is enthusiasticallyoffering "products" (read $$$) to "help" doctorsmeet their performance goals.
It is beyondtime for new professional societies to emerge that actually advocatefor physicians involved directly in patient care. Perhaps one big"Society for Patient Care Physicians" that could involveeveryone who actually sees patients every day, rather than theacademic guideline and rule-writing "doctors" who dominatesocieties today.” - Unquote.
I think the comment is on target andneeds to be done so that doctors that care for and about patientscould have a format to get information to patients in terms theyunderstand and this could be promoted for patients. With theInternet of today, what could be of value to patients is often lostin the dogma of the medical organizations. Most could have on theirhome page a link to patient information and then links on the patientpage for more pages of valuable information. This information couldthen be reliable information that can be used for the benefit ofpatients and used by patients.
Even the website for approved Internetwebsites on the AACE website no longer has a direct link to it on thehome page. Plus, they are not adding anymore approved sites. Theyhave fulfilled their promise so-to-speak, and now want to leave italone. For the two sites of the AACE and ACE, there is so muchinformation that could be included as part of their websites. However, at most, the information is limited for patients and notreally informative for new patients that may be searching these sitesfor reliable information.
On the same site is a tab named “TheABCs of Diabetes Management.” This did not surprise me as they areA1c, blood pressure, and cholesterol. Surprise, no mention is madeabout statins. Blood pressure goals are different than recommendedby the American Heart Association, but not significantly higher. From the way the material is presented, the emphasis seems very muchon the HbA1c as the measurement for how well the goals are beingaccomplished not any individual blood glucose tests. At least theA1c goal is 6.5%, but then they say that maybe the goal will need tobe higher. No mention is made about individuals that want to strivefor lower A1cs or if they will even allow for this.
Then they use four topics to help inachieving the ABCs. They include healthy eating, getting moreactive, taking your medication, and tracking your ABC goals. I wastotally surprised at the healthy eating. They rightly say to limitrefined foods and eat vegetable and some fruits. Maybe a littleheavy on the fruits, but no mention of whole grains. The limiteddiscussion on getting more active was not bad, but the discussionmissed a lot of physical activity. Taking your medication(s) did notdiscuss any particular medication(s), but the suggestion is there. The concern for hypoglycemia is present and that is a plus. Trackingyour ABC goals missed more than it covered. It talks about trackingyour blood glucose levels, but does not give any meaning to why trackand what to be looking for in meaning. To me, it sounds more likethe reason is for the doctor than looking for reasons to the dailynumbers.
In the medscape interview, FarhadZangeneh, MD, FACP, FACE did a good thing in answer to a questionabout why not use the more effective treatment of bariatric surgeryfor all obese type 2 patients than have them struggle with lifestylechanges to achieve treatment goals. I will quote his answer - “Notall patients with type 2 diabetes are candidates for bariatric ormetabolic surgery, and no matter how much weight is initially lost,there is always weight rebound. There are no easy answers and noshortcuts in the management of diabetes. Even if patients arecandidates for bariatric surgery, their psychology — mindset andeating behavior — has to change before their anatomy. There isalso growing evidence that patients who undergo gastric bypasssurgery are prone to hypoglycemia. For the majority of patients withdiabetes, management still boils down to healthy eating, physicalactivity, and pharmacological medical management.”
As for the goals of “The Game Plan,”most of the information is on a need to be done basis and noteducation about diabetes and the reasons for doing what is all butdemanded that patients do. Some information is there and for somepatients that function in this manner, it may be of value.
What I think is that few people aregoing to find this site without a direct link to it from the AACEmain page or even a link from the ACE page. Few patients with type 2diabetes ever read the articles from the medscape dot com site and Ihave not seen any other mention of the site elsewhere. Granted I donot read every website, but I think Merck was sold an idea with nosolid intention of promoting the website by AACE. Some people willfind the website from search engine use, but that will be a smallnumber. Great idea, but no support of the site by AACE.