The American Association of Clinical Endocrinologists (AACE) has released its new medical guidelines for diabetes. Needless to say, the 66-page guidelines are intended for your doc, not for you. Unless you are having trouble getting to sleep at night...

But they're important for you to know about. Very. The guidelines are the first reference point for physicians determining the best course of care for diabetes patients. Blood sugar, blood pressure, type 1, type 2, pregnancy, metabolism, prevention etc etc. It's all in there.

So what's new? According to AACE president Dr. Richard Hellman, the focus is, for the first time, on patient safety - specifically, reducing the incidence of medical errors involving diabetes patients. "These guidelines are the first that specifically point to how best to protect the patient with diabetes against mistakes and misjudgments by all those who directly or indirectly impact their diabetes care, including themselves," said Dr. Hellman. "Patient safety is not a given."

The guidelines are being published as a supplement to the latest issue of Endocrine Practice (May/June 2007), the journal of the AACE. They can also be accessed online. Click here to view the pdf.

A white elephant is a supposedly valuable possession whose upkeep exceeds its usefulness, and it is therefore a liability. Every type 2 diabetic is a valuable possession to someone: a mother, a father, a sister, a brother, a daughter, a son...you get the picture. But when it comes to the complications of the disease - it costs the U.S. health system an extra $22.9 billion a year to treat these complications.

"It is a pretty significant wake-up call for people, or should be. It really points out the importance of managing the disease," said Willard Manning, a health economist at the University of Chicago who worked on the report.

Dr. Daniel Einhorn says "the fact that people are still getting complications means we are not using our tools effectively enough," When people fail to follow their diet, exercise and drug treatment plans, the disease leads to complications that boost the total health bill to $57.1 billion. "Either the patient doesn't recognize they have it and complications develop, or they are not good about adhering to their doctor's orders," he said, adding, "We've got to do a better job of managing the disease." Dr. Einhorn serves on the board of the American Association of Clinical Endocrinologists.

Of course, it's the patient -- NOT the drugs they are using. It couldn't possibly be the drugs.

Some of the world's foremost experts on diabetes are participating in a major conference, currently underway in Chicago (April 26-30). It is the fifteenth annual meeting of the American Association of Clinical Endocrinologists (AACE). Speakers include C. Ronald Kahn, of the Joslin Diabetes Center, and Mary K. Iacocca of Harvard Medical School. Kahn and Iacocca will be presenting results of new research linking Type 2 diabetes and genetics. (See my previous blog, by the way, for more on that link.) Some other topics up for discussion include methods of screening for diabetes and the prediction of gestational diabetes. In addition, a wealth of other topics will be covered as well, relating to other types of endocrine disorders.

This is my first report from the front line of people deciding the best “evidence based” medical ways to take care of people with diabetes that are in the hospital. It is Day One of the American Association of Clinical Endocrinologists (AACE) meeting and the sole purpose is to develop a consensus statement about how patients with diabetes should have their blood sugar managed in the hospital setting. I spent an entire day inside a hotel with physicians, nurses, dietitians and even hospital administrators listening to the compelling evidence that controlling blood sugars in hospitalized patients with diabetes not only saves lives and prevents complications, but protects them from complications long after they are discharged. What an exciting day! As I said in a previous blog, this is and certainly was today, the Academy Awards of diabetes medical treatment research presentations. The speakers were passionate about their research findings and results. At this point in the conference, everyone is simply presenting compelling reasons to do a good job managing blood sugars when a person with diabetes is in the hospital, so no conclusions have been reached. The wonder of it all is the process of presenting such incredibly stunning statistics that in the final analysis will benefit everyone with diabetes. As one of the presenters stated after presenting his results “as far as survival, it is an advantage now to have diabetes”! I am paraphrasing, but as a person with diabetes I honestly felt that way after hearing the presentations! P.S. Doctors eat really well at these events!