New Diabetes Campaign Raises Controversy
Nov. 18, 2004 — -- A national public service campaign aims to convince individuals with Type II diabetes that getting a simple blood test will help them stay healthy, but some doctors fear this strategy may lull diabetics into ignoring other serious health concerns.
A coalition of 50 U.S. mayors and health advocates brought its message to Washington today to launch the effort, called "Aim. Believe. Achieve: The Diabetes A1C Initiative." The goal is to raise awareness of a test for hemoglobin A1C, a molecule formed when sugars bind to hemoglobin circulating in the blood.
The test is usually performed every three or four months, usually in a doctor's office. The physician needs just a drop of blood to read the patient's A1C value.
Most diabetics are already experienced at checking their blood-sugar levels frequently during the day using a home device. But these blood-sugar tests show a patient's level at a single point in time, and levels may fluctuate wildly with diet and after a patient takes medications. An A1C test reflects a person's average sugar levels over a two- to three-month period, giving a more stable picture of blood-sugar control.
Proponents of the initiative argue this is the best way to discover how effective treatment has been. They say diabetics should have their A1C checked frequently, aiming for a value of less than 7 percent.
But some in the medical community believe the campaign -- largely funded by Aventis, maker of the Type II diabetes medication Amaryl -- will mislead patients into believing that keeping their blood-sugar level within normal limits is a cure-all for the disease.
"Imagine you are a doctor sitting in front of a patient with Type II diabetes holding up your hand with all five fingers extended," said Dr. David Slawson, a professor of family medicine at the University of Virginia.
"The thumb is smoking, the index finger is blood pressure, the third and fourth fingers are lipids, aspirin, and a particular diabetic medication, metformin, and the pinky is blood sugar," he said. "The first four fingers dwarf the pinky, which is the least important, if at all."
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