Despite some progress in reducing the rate of diabetic complications, the epidemic rise in incidence of diabetes mellitus ensures that there will be an increasing number of patients in the coming decades with complex health care management issues who will need efficient and effective care. The management of patients with diabetes is an ever-challenging endeavor attributable to several factors. These include, among others, (1) limited provider expertise, (2) decreasing time of a patient visit, (3) increasing complexity of drug management, (4) limited use of self-monitoring of blood glucose by patients and/or providers, (5) clinical inertia, and (6) nonadherence. Technology-driven innovative solutions, including those using virtual reality, are desperately needed to assist both patients and their providers in overcoming the exigencies of this protean disease.
CowieCCRustKFByrd-HoltDDGreggEWFordESGeissLSBainbridgeKEFradkinJE. Prevalence of diabetes and high risk for diabetes using A1C criteria in the U.S. population in 1988–2006. Diabetes Care.2010;33 (3): 562–8.
2.
YangWLuJWengHJiaWJiLXiaoJShanZLiuJTianHJiQZhuDGeJLinLChenLGuoXZhaoZLiQZhouZShanGHeJ, China National Diabetes and Metabolic Disorders Study Group. Prevalence of diabetes among men and women in China. N Eng J Med.2010;362 (12): 1090–101.
NarayanKMBoyleJPThompsonTJSorensenSWWilliamsonDF. Lifetime risk for diabetes mellitus in the United States. JAMA.2003;290 (14): 1884–90.
5.
FongDSAielloLGardnerTWKingGLBlankenshipGCavalleranoJDFerrisFL3rdKleinR, American Diabetes Association. Retinopathy in diabetes. Diabetes Care.2004;27Suppl 1: S84–7.
6.
American Diabetes Association. Economic costs of diabetes in the U.S. in 2007. Diabetes Care.2008;31 (3): 596–615.
7.
Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New Engl J Med.1993;329 (14): 977–86.
8.
OhkuboYKishikawaHArakiEMiyataTIsamiSMotoyoshiSKojimaYFuruyoshiNShichiriM. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: A randomized prospective 6-year study. Diabetes Res Clin Pract.1995;28 (2): 103–17.
9.
UK Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet.1998;352 (9131): 837–53.
10.
American Diabetes Association. Standards of medical care in diabetes-2010. Diabetes Care.2010;33Suppl 1: S11–61.
11.
RodbardHWBlondeLBraithwaiteSSBrettEMCobinRHHandelsmanYHellmanRJellingerPSJovanovicLGLevyPMechanickJIZangenehF, AACE Diabetes Mellitus Clinical Practice Guidelines Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus. Endocr Pract.2007;13Suppl 1: 1–68.
NathanDMClearyPABacklundJYGenuthSMLachinJMOrchardTJRaskinPZinmanB, Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med.2005;353 (25): 2643–53.
14.
HolmanRRPaulSKBethelMAMatthewsDRNeilHA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med.2008;359 (15): 1577–89.
15.
MenzinJLangley-HawthorneCFriedmanMBoulangeLCavanaughR. Potential short-term economic benefits of improved glycemic control: A managed care perspective. Diabetes Care.2001: 24 (1): 51–5.
16.
CDC Diabetes Cost-effectiveness Group. Cost-effectiveness of intensive glycemic control, intensified hypertension control, and serum cholesterol reduction for type 2 diabetes. JAMA.2002;287 (19): 2542–51.
17.
Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med.1993;329 (14): 977–86.
18.
Diabetes Control and Complications Trial Research Group. Lifetime benefits and costs of intensive therapy as practiced in the diabetes control and complications trial. JAMA.1996;276 (17): 1409–15.
19.
GilmerTPO'ConnorPJManningWGRushWA. The cost to health plans of poor glycemic control. Diabetes Care.1997;20 (12): 1847–53.
20.
HermanWHEastmanRC. The effects of treatment on the direct costs of diabetes. Diabetes Care.1998;21Suppl 3: C19–24.
21.
HoergerTJSegelJEGreggEWSaaddineJB. Is glycemic control improving in U.S. adults? Diabetes Care.2008;31 (1): 81–6.
22.
CheungBMOngKLChernySSShamPCTsoAWLamKS. Diabetes prevalence and therapeutic target achievement in the United States, 1999 to 2006. Am J Med.2009;122 (5): 443–53.
23.
RizzaRAVigerskyRARodbardHWLadensonPWYoungWFJrSurksMIKahnRHoganPF. A model to determine the workforce needs for endocrinologists in the United States until 2020. J Clin Endocrinol Metab.2003;88 (5): 1979–87.
24.
BaronRJ. What's keeping us so busy in primary care? A snapshot from one practice. N Eng J Med.2010;362 (17): 1632–6.
25.
GottschalkAFlockeSA. Time spent in face-to-face patient care and work outside the examination room. Ann Fam Med.2005;3 (6): 488–93.
IzquierdoREKnudsonPEMeyerSKearnsJPloutz-SnyderRWeinstockRS. A comparison of diabetes education administered through telemedicine versus in person. Diabetes Care.2003;26 (4): 1002–7.
28.
PetersALDavidsonMB. Application of a diabetes managed care program. The feasibility of using nurses and a computer system to provide effective care. Diabetes Care.1998;21 (7): 1037–43.
29.
AlaouiAClementSKhanaferNCollmannJLevineBMunSK. Diabetes home monitoring project. PACMEDTEK Symposium, Honolulu Hawaii, August 1998.
30.
OberSKNaitoHLowMECutreKFCrockettDSkalaMDAsberryMTSchumacherPOGalenRS. A Web-based internet system of diabetes management. Diabetes.2000;49Suppl 1: Abstract 484.
31.
PrendergastJBagdadeJMayesPPerrotM. Diabetes mellitus management with internet augmentation. Endocrine Society Annual Meeting, 2000, Toronto, Canada. Abstract 1823.
32.
VigerskyRAAndersonTFilmoreAThomas-WhartonDNovakLHeltzelIJSmithDKesslerCClarksonJStriegelALoughneyMGalenRS. The use of telemedicine in the management of poorly controlled patients with diabetes mellitus. Endocrine Society 85th Annual Meeting, Philadelphia, PA, 2003.
33.
GrantRWWaldJSSchnipperJLGandhiTKPoonEGOravEJWilliamsDHVolkLAMiddletonB. Practice-linked online personal health records for type 2 diabetes mellitus: A randomized controlled trial. Arch Intern Med.2008;168 (16): 1776–82.
34.
SchüttMKernWKrauseUBuschPDappAGrziwotzRMayerIRosenbauerJWagnerCZimmermannAKernerWHollRW, DPV Initiative. Is the frequency of self-monitoring of blood glucose related to long-term metabolic control? Multicenter analysis including 24,500 patients from 191 centers in Germany and Austria. Exp Clin Endocrinol Diabetes.2006;114 (7): 384–8.
35.
MartinSSchneiderBHeinemannLLodwigVKurthHJKolbHScherbaumWA. Self-monitoring of blood glucose in type 2 diabetes and long-term outcome: An epidemiological cohort study. Diabetologia.2006;49 (2): 271–8.
36.
KarterAJFerraraADarbinianJAAckersonLMSelbyJ V. Self-monitoring of blood glucose: Language and financial barriers in a managed care population with diabetes. Diabetes Care.2000;23 (4): 477–83.
37.
BrownJBNicholsGAPerryA. The burden of treatment failure in type 2 diabetes. Diabetes Care.2004;27 (7): 1535–40.
38.
BerlowitzDRAshASHickeyECFriedmanRHGlickmanMKaderBMoskowitzMA. Inadequate management of blood pressure in a hypertensive population. N Eng J Med.1998;339 (27): 1957–63.
39.
KrapekKKingKWarrenSSGeorgeKGCaputoDAMihelichKHolstEMNicholMBShiSGLivengoodKBWaldenSLubowskiTJ. Medication adherence and associated hemoglobin A1c in type 2 diabetes. Ann Pharmacother.2004;38 (9): 1357–62.
40.
PladevallMWilliamsLKPottsLADivineGXiHLafataJE. Clinical outcomes and adherence to medications measured by claims data in patients with diabetes. Diabetes Care.2004;27 (12): 2800–5.
41.
KuoYFRajiMAMarkidesKSRayLAEspinoDVGoodwinJS. Inconsistent use of diabetes medications, diabetes complications, and mortality in older Mexican Americans over a 7-year period: Data from the Hispanic established population for the epidemiologic study of the elderly. Diabetes Care.2003;26 (11): 3054–60.
42.
HeislerMHoganMMHoferTPSchmittdielJAPladevallMKerrEA. When more is not better: Treatment intensification among hypertensive patients with poor medication adherence. Circulation.2008;117 (22): 2884–92.
43.
ReachG. Can technology improve adherence to long-term therapies?J Diabetes Sci Technol.2009;3 (3): 492–9.
