Early detection, education key for diabetics

124,000 cases in state undiagnosed, expert says; disease has high risks

Early detection and education are key in managing a growing diabetic population in Arkansas, health officials said.

The Arkansas Department of Health estimates that 372,000 people in Arkansas have diabetes. About 124,000 of those individuals are unaware that they have it, said Appathurai Balamurugan, Arkansas Department of Health medical director for the Chronic Disease Prevention and Control Branch.

Balamurugan said diabetes is the leading risk factor for other health problems, including heart disease, stroke, kidney failure and amputations.

"If people can be prevented from having diabetes, than these risks would not happen," Balamurugan said. "We would not have the pain and suffering of diabetes along with the costs to the health care system."

In Arkansas, diabetes medical and indirect costs -- such as loss of productivity -- were estimated at $3 billion in 2012, according to a report published in Diabetes Care that Balamurugan supplied.

The public and health care providers need to be educated on testing for diabetes along with detecting pre-diabetic conditions, Balamurugan said.

"Physicians have to be on the lookout for these individuals," Balamurugan said. "When I see an adult who is obese and physically not active and has high blood pressure, that is a warning sign to me to screen for diabetes. If they fall in the range of pre-diabetes, that is the time to intervene."

The public should be aware of diabetic symptoms such as increased hunger and thirst along with frequent urination, Balamurugan said. Blurred vision, tiredness and tingling sensations or numbness in hands or feet are also symptoms.

Balamurugan said a lot of patients learn that they are diabetic after an episode such as fainting.

There also needs to be a push for educating people after they are diagnosed with diabetes or pre-diabetes, Balamurugan said. This includes taking blood tests to monitor blood sugar levels, along with monitoring blood pressure and cholesterol.

Charles W. Smith, director of the primary care service line at the University of Arkansas for Medical Sciences, said treating diabetes requires a team approach. That includes a doctor, a dietitian and sometimes a behavioral counselor. Care managers also help patients keep track of appointments.

"Once a patient is diagnosed, they need to have some time spent with professionals who can educate the patient about this disease," Smith said. "It takes a team to really manage a diabetic population."

Smith said team meetings are used to inform members about outcomes along with the effectiveness of treatments.

The Arkansas Diabetes Advisory Council was established in 1998 and is made up of private and public health care officials. Patient and provider education is a goal of the committee.

The council has organized numerous presentations across the state on the subject and developed a tool kit designed for patients and doctors, said Bonnie Bradley, Arkansas Department of Health public health nutrition consultant and co-chairman of the state Diabetes Advisory Council.

More than 300 providers received training on diabetes during conferences held in the state over the past two years, Bradley said. She said educational material also has been sent to about 3,000 primary care providers in the state in recent years.

NW News on 12/15/2014

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