The medicine isn’t going down

From San Antonio, Texas, at the 60th annual meeting of the American Diabetes Association

Most people with diabetes don’t take their medications often enough to keep their disease under control, according to new research. Moreover, physicians don’t prescribe medications to control hypertension and high blood concentrations of cholesterol to all the diabetic patients who need them.

“Only one-third of people with type II diabetes have their prescriptions filled often enough to take at least 90 percent of their pills,” says Andrew D. Morris of the University of Dundee in Scotland. Over a 3-year period, he and his colleagues tracked 3,494 patients diagnosed with diabetes in Scotland and compared the quantity of drugs prescribed by physicians with the amount dispensed by pharmacies.

Only 13 percent of people taking two medications for their diabetes filled 90 percent of their prescriptions, he says. People who were best off financially and those most recently diagnosed with diabetes were most likely to fill their prescriptions.

Diabetes, characterized by high blood sugar concentrations that result from the body’s inability to produce insulin or use it effectively, affects about 16 million people in the United States. Without careful control, it can lead to complications including blindness, kidney disease, and heart disease.

“These serious complications are preventable, but they require compliance” with physicians’ treatments, says Gerald Bernstein of Beth Israel Medical Center in New York.

Because people with diabetes are also predisposed to heart disease, their physicians should treat abnormally high concentrations of blood cholesterol aggressively, says Deborah B. Rolka of the Centers for Disease Control and Prevention in Atlanta. High cholesterol has been linked to heart disease.

Rolka and her colleagues found that among a nationally representative sample, more than 76 percent of people with diabetes had an abnormally high cholesterol concentration in their blood. Yet only 32 percent of the participants reported being treated for it. Most concerning, she says, only 1 percent of those getting anticholesterol treatments had reduced their blood cholesterol to normal concentrations.

A majority of the 71 percent of diabetics with hypertension—another predictor of heart disease—was being treated for it. However, physicians were treating only 12 percent aggressively enough to lower their blood pressure to the national goal of 135/85, Rolka reports.

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