Blog | Thursday, July 24, 2008

Guidelines aim to clarify treatment of pre-diabetes

The American College of Endocrinology last week issued its first guidelines on managing patients with pre-diabetes, suggesting aggressive lifestyle control as the first line of defense in warding off full-blown disease, followed by selective drug treatment and frequent monitoring of symptoms.

The guidelines recommend prescribing metformin or acarbose to high-risk patients, such as those with cardiovascular disease or worsening glycemia; statins to lower LDL cholesterol to 100 mg/dL; and ACE/ARB inhibitors to reach target blood pressure of 130/80 mmHg. Patients should undergo glucose and microalbuminuria testing annually and have fasting plasma glucose, hemoglobin A1C and lipids tests every six months, the guidelines state.

Physicians often have little success getting patients to embrace lifestyle changes, such as following a low-fat diet and exercising daily, as recommended in the guidelines. Will the new recommendations encourage more use of medications to control symptoms in patients at risk for diabetes? What are you doing in your practice?