Many diabetics missing out on protective drugs

Reported by Susan Aldridge, PhD, medical journalist

A study shows that nearly half of older diabetics do not receive drugs that could protect them from complications.
Heart and kidney disease are the main complications of diabetes - but there are drugs that can reduce the risk. However, a study from the University of Michigan now reveals that not all who can benefit from these drugs actually receive them.

They looked at the use of drugs such as angiotensin converting enzyme (ACE) inhibitors in a group of diabetics over 55. For each person, three clinical indications of increased risk were assessed. These were the existence of any kind of heart disease, high blood pressure, and the presence of protein in the urine (a sign of impaired kidney functioning). According to national guidelines, the presence of any of the three means the patient needs to be on preventive medication like ACE inhibitors.

In this study, 92 per cent had at least one of the above high risk indications. Those who did not still had at least one risk factor for heart disease. The more risks and indications a person had, the more likely they were to be taking the drugs - but even in the highest risk group, only 53 per cent were on them. The study did not reveal why the usage of the drugs was so low - lack of physician and patient awareness could be one reason, however. Another reason might be the cost to patients. New ways need to be found to ensure that all patients who can benefit from preventive medication in diabetes has access to it.

Source
Journal of General Internal Medicine April 2006

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