Acute Care of Patients With Diabetes: Preface
- Abbas E. Kitabchi, PhD, MD, FACP, FACE
Diabetes mellitus has reached epidemic proportions not only in the United States but also worldwide.1 Diabetes is the leading cause of end-stage renal disease, adult blindness, and nontraumatic lower limb amputation2 and ranks seventh as a cause of death in this country. The incidence of cardiovascular events, as well as renal disease and glaucoma, is increased manyfold in patients with diabetes.3,4
Landmark studies such as the Diabetes Control and Complications Trial5 and the United Kingdom Prospective Diabetes Studies6 demonstrated that control of blood glucose in both type 1 and type 2 diabetes results in significant risk reduction of microvascular diseases. But despite that conclusive evidence, the incidence of acute complications of diabetes has not been significantly reduced and in fact is on the rise.7 This can be attributed in part to the inaccessibility of health care to certain segments of the population, inadequate dissemination of practice guidelines to health care providers, and/or patients’ difficulty in following recommended guidelines.
The national hemoglobin A1c average for patients with diabetes remains alarmingly high.8 Only 13% of such patients achieved the goal of <7% in a long-term follow-up study.6 Subsequently, uncontrolled diabetes leads to a greater number of acute and chronic complications and hospital …
