[CITATION][C] Successful treatment of Type B insulin resistance in a patient with otherwise quiescent systemic lupus erythematosus
Diabetic medicine, 2005•Wiley Online Library
Type 2 diabetes mellitus is a major health issue as it is associated with acute and chronic
complications, disability and premature death, higher health care costs and lost productivity
[1, 2]. A recent overview of 25 years of Centers for Disease Control and Prevention research
and programs on diabetes issued an urgent call for greater efforts to delay or prevent (the
complications of) diabetes [1]. Screening for diabetes plays a crucial role as its benefits
originate from earlier diagnosis and treatment of diabetes, thereby postponing or preventing …
complications, disability and premature death, higher health care costs and lost productivity
[1, 2]. A recent overview of 25 years of Centers for Disease Control and Prevention research
and programs on diabetes issued an urgent call for greater efforts to delay or prevent (the
complications of) diabetes [1]. Screening for diabetes plays a crucial role as its benefits
originate from earlier diagnosis and treatment of diabetes, thereby postponing or preventing …
Type 2 diabetes mellitus is a major health issue as it is associated with acute and chronic complications, disability and premature death, higher health care costs and lost productivity [1, 2]. A recent overview of 25 years of Centers for Disease Control and Prevention research and programs on diabetes issued an urgent call for greater efforts to delay or prevent (the complications of) diabetes [1]. Screening for diabetes plays a crucial role as its benefits originate from earlier diagnosis and treatment of diabetes, thereby postponing or preventing progression to diabetes complications, such as nephropathy, neuropathy, retinopathy and especially cardiovascular disease. The few studies that have examined the cost-effectiveness of screening for Type 2 diabetes have focused on patients who present themselves to physicians and who are screened during an already scheduled physician visit [3–5]. There may be a role for pharmacists to contribute to targeted screening by informing people about Type 2 diabetes and encouraging high-risk people to visit a physician to be screened. A pilot project was launched in three Belgian towns at the end of 2003 which drew on local community pharmacists to distribute a folder on Type 2 diabetes to people visiting the pharmacy. The folder provided general information about Type 2 diabetes and contained a number of questions investigating the presence of risk factors for diabetes (eg obesity, hypertension, age, family history of diabetes). The development of the folder was based on a literature review and was validated by six diabetologists. If at least one risk factor was present, the person was invited to consult a primary care physician. Data were gathered on the number of people consulting a primary care physician and the number of new diabetic patients identified as a result of the distribution of the folder in community pharmacies.
During the 3 months that folders were distributed in community pharmacies, 782 people consulted their primary care physician in order to be screened, culminating in the identification of 39 new diabetic patients (see Table 1). This yields a number needed to screen of 20 people to identify one undiagnosed diabetic patient and falls within the range of 13–48 people needed to screen reported in a previous study [4]. Other benefits of the project are that the involvement of community pharmacists has aided in screening a number of people who never visit a primary care physician, but who occasionally buy drugs. The process of screening people for diabetes was also accompanied by the discovery of other medical conditions such as hypertension and elevated cholesterol level. Although it was not possible to follow-up patients to calculate savings in
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