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Volume 34, Number 1 (May/June)

Communicating with Patients with Diabetes: A Paradigm Shift (pages 17-21)

Ellen D. Davis, M.S., R.N., C.D.E., F.A.A.D.E., Marjorie Pierre-Louis, A.P.R.N., M.S.N, N.P.-C.

Traditional methods of communicating with diabetes patients could be made more effective. Diabetes professionals can do this by shifting their focus from what to tell patients to do at home to manage their diabetes the larger issue of learning how to talk with patients using evidence-based standards of communication and care that have been shown to improve clinical outcomes.

Lifestyle Interventions to Treat Prediabetes (pages 3-10)

Katie Cristina Portero McLellan, Ph.D., Kathleen Wyne, M.D., Ph.D., Evangelina Trejo Villagomez, Ph.D., Willa A. Hsueh, M.D.

Prediabetes is defined as a state of abnormal glucose homeostasis characterized by impaired fasting glucose, impaired glucose tolerance, or both. Microvascular and macrovascular damage starts during prediabetes and is associated with an increased risk of cardiovascular disease early in the progression to Type 2 diabetes. We need to consider the health risk and economic burden of prediabetes. Unfortunately, prediabetes is not considered a disease but rather as a risk or a “pre” stage for diabetes; thus, this condition has not been addressed by regulatory agencies in terms of prevention or management.
Management strategies and tools

Cardiometabolic Risk, Metabolic Syndrome, and Diabetes: Dysmetabolism and Cardiovascular Risk (pages 11-16)

Devan Shan, Samir Desai, M.D.

Recent guidelines have recommended that all people with diabetes between the ages of 40 to 75 years receive statin therapy. However, while statins lower cholesterol, they do not remove all cardiometabolic risk. Management of both diabetes and prediabetes has traditionally been focused on glucose control but needs to be expanded to address all components of the Metabolic Syndrome. This review will address identification and treatment of cardiometabolic risk factors.
Complications and comorbiditiesCardiovascular disease

Driving With Diabetes (pages 22-23)

Kathleen Wyne, M.D., Ph.D.

One of the challenges of diabetes management for clinicians is that we never have enough time to discuss all of the issues we would like to cover in each clinic visit. General guidelines regarding diabetes and driving are usually presented during diabetes education courses…and then not discussed again after that class. If an individual is diagnosed with diabetes before he or she is old enough to obtain a driver’s license, this subject may never have been raised. A few studies have been done on the risks of driving when one has diabetes, but there are no statistics available to tell us how often a motor vehicle accident is related to diabetes.
Special activities with diabetesDriving