Despite an explosive epidemic of diabetes, two major doctors’ groups say not enough is being done to control the disease in those who have it and prevent it in those at risk.

A new report shows that there is a major gap between recommended diabetes management guidelines (search) and what's being done in the real world.

Researchers say too few people are controlling their diabetes and keeping their blood sugar levels as normal as possible. The groups also recommend that screening for diabetes begin at age 30 among people at risk, such as those with a family history of the disease or who are overweight.

The prevalence of diabetes has grown by more than 40 percent in the 1990s, and more people are getting the disease at an earlier age, with the prevalence of diabetes increasing by 70 perecent in adults 30 to 39 years old.

Studies show that aggressive treatment of diabetes can drastically reduce the risk of complications, such as heart disease, kidney disease, and loss of limbs, and currently available medications are capable of lowering blood sugar to near normal levels in most people with diabetes.

But even with these advances, researchers say diabetes management has actually worsened in the last decade.

"Patients with diabetes are often in denial," says Jaime A. Davidson, MD, chair of the conference of the American College of Endocrinology (search) and American Association of Clinical Endocrinologists (search), which released the report, in a news release. "The problem only mushrooms when physicians miss the window of early detection and treatment."

The two doctors' groups released diabetes management guidelines in 2001, but the results of their two-day conference to assess progress since then shows there is a noticeable lack of compliance among patients and doctors.

Better Diabetes Care Needed

The report recommends the following steps to improve diabetes treatment and prevention:

Improve diabetes screening: Test people at risk for type 2 diabetes, detect and treat impaired glucose tolerance (a common precursor to diabetes) starting at age 30, and educate them about reducing their risk.

Intervene early: Initiate treatment early and persistently check blood sugar levels of patients with existing diabetes to improve quality of life and reduce the risk of later complications. This may involve starting therapy with two or more drugs in addition to lifestyle changes.

Promote self-management of diabetes: Educate patients about the disease, proper management, and potential complications of the disease. Use frequent blood sugar monitoring to make more informed decisions about therapy and the effect of eating and exercise on glucose control. Good control means keeping blood sugar levels below 110 before eating and below 140 two hours after eating.

"Diabetes as we know it today is more complex than we once thought, and the treatment is even more complex," says Davidson. "However, the ACE/AACE guidelines for diabetes management are achievable when patients work closely with their physicians and other members of their health care team."

By Jennifer Warner, reviewed by Brunilda Nazario, MD

SOURCE: News release, American College of Endocrinology and American Association of Clinical Endocrinologists.