Seventy-nine million Americans are estimated to have prediabetes.
“So…do I have diabetes or not, doc?” my patient asked me, one eyebrow raised skeptically. Juan was a mechanic with a calm gaze; we had first met in the emergency room a few months earlier, when I treated him for high blood pressure. Now I explained how his blood tests indicated that he had “prediabetes,” a condition that put him at higher risk for developing diabetes and its complications, including heart problems, kidney disease, and stroke.
“Does that mean I have to take more pills?” was Juan’s next question. I hesitated. The answer wasn’t straightforward, but the reality was that he was likely to require more medication at some point in the near future. Until then, all I had to offer were my best efforts at persuading him to exercise and improve his diet.
Seventy-nine million Americans are estimated to have prediabetes. More are at risk for other chronic diseases, such as cancer, cardiovascular disease, and lung disease. Many of these illnesses stem from four common risk factors: tobacco use, poor diet, lack of physical activity, and alcohol use. Yet too often, as with Juan, a doctor’s diagnosis is the first time a patient realizes they are even at risk for chronic disease. To change this, we need better preventive medicine.
A new preventive medicine would capitalize on three scientific convergences: the ability to detect predisease states earlier; more patient-centered health care models; and advances in risk factor interventions.
Detecting predisease states is not a novel concept. Pap smears, first introduced in 1928, essentially screen for precancerous tissue in the cervix; colonoscopy can serve the same purpose for intestinal cancer. Beyond oncology, predisease states include prehypertension (for high blood pressure) and osteopenia (for osteoporosis). But more sophisticated risk prediction, sometimes incorporating genetic information, may help push the detection of predisease states further upstream. For example, the U.S. Preventive Services Task Force recently recommended that women with a family history of breast, ovarian, and certain other cancers undergo genetic risk assessment. Depending on the results of this assessment, women should receive genetic counseling and, if indicated, testing for mutations in the BRCA1 and BRCA2 cancer susceptibility genes. In another example, technology to better identify predisease states could be developed around the urine metabolome, a database of detailed information on over 3,000 chemical compounds found in human urine.
Patients like Juan who are at risk for chronic diseases may also benefit from the burgeoning “consumer biometrics” movement. Startups like mc10 and Scanadu seek to enable personal monitoring of physiologic parameters like blood pressure, heart rate, temperature, and blood oxygenation. Tracking this information provides a richer set of data for clinicians and scientists, and individuals are empowered to understand their own data, potentially leading to greater engagement with their health issues. For instance, mc10, building on research by John Rogers at the University of Illinois at Urbana-Champaign, is prototyping ultrathin, flexible, skin-adherent devices akin to smart Band-Aids. One potential application is continuously monitoring blood sugar—without needles.
Along with consumer biometrics, more convenient care models promise to expand the locus of health care beyond hospitals and clinics. New patient-centered care options such as retail clinics have expanded rapidly in recent years; several major pharmacies including CVS, Caremark and Walgreens, and retailers such as Wal-Mart either have clinics or plan to launch them. Retail clinic visits were estimated to account for almost 6 million annual visits in 2012. While most visits are for simple health issues like sore throats or routine immunizations, the distributed infrastructure of retail clinics may be just as beneficial for addressing complicated, chronic diseases like diabetes. A recent partnership between Walgreens and Theranos, a company offering cheap, complete blood analysis with just a fingerstick, demonstrates how this might advance prevention. Integrating real-time laboratory capacity with medical expertise at retail clinics—and including lifestyle coaching like nutritional counseling for prediabetics—offers a convenient, comprehensive preventive medicine package.
Ultimately, earlier illness diagnosis is fruitless without effective interventions to stave off disease progression.
The Latest on: Preventive Medicine
via Google News
The Latest on: Preventive Medicine
- Preventive Medicine: Can your lifestyle be medicine?on May 11, 2021 at 4:52 am
Since the seminal work of McGinnis and Foege, a vast expanse of science, spanning decades, diverse populations, and varied methods confirms that most of what plagues modern societies is preventable by ...
- Can Lifestyle Be Medicine?on May 9, 2021 at 1:48 pm
At most, it’s a minor exaggeration to say that a single, scientific publication altered the trajectory of my career.
- Bio Preventive Medicine Corp.on May 4, 2021 at 1:42 am
The Biotechnology Innovation Organization is the world's largest biotech trade association. Learn about BIO, register for events and explore member services.
- Steven Jonas, M.D., M.P.H., M.S., FNYAS, has been recognized with the Albert Einstein Award of Medicine by the International Association of Who's Whoon April 30, 2021 at 9:22 pm
Dr. Jonas has been commended for his accomplishments in the field of Preventive Medicine and Public Health, an area he has worked in for ...
- Preventive Medicine Market 2021: Covid-19 Impact Analysis,Growth Factors,Global Growth,Analysis By 2027 | FMI Reporton April 30, 2021 at 12:14 am
Global Preventive Medicine Market Report Update 2021 by Key Players, Segments, Countries, Market Size, Forecast to 2027 (Based on 2020 COVID-19 Worldwide Spread) is latest research study released by ...
- Episode 49: How genomic sequencing is enhancing veterinary medicineon April 28, 2021 at 8:28 am
On this episode of The Vet Blast Podcast, Dr Christman is joined by Dr Kock, a market development manager at NEOGEN who discusses the nuts and bolts of genomic sequencing, including its unique role in ...
- Preventive Healthcare and Wellness Marketon April 27, 2021 at 11:49 pm
A new business intelligence report released by HTF MI with title COVID 19 Outbreak Global Preventive Healthcare and Wellness Industry Market Report Development Trends Threats Opportunities and ...
- Preventive Medicine: Concern about vaccine risk is understandableon April 19, 2021 at 3:36 am
History is rife with plagues and pandemics, many orders of magnitude worse than this one. Eventually, they all did end. This one will, too. The first thing to note is how fraught with peril ...
- RenalTech inspires more veterinary visits and better preventive care for catson April 13, 2021 at 4:04 am
RenalTech intersects Antech's advanced laboratory testing with innovative statistical data analysis to provide truly preventive medicine instead of reactionary." RenalTech is the first in a series ...
- Feinstein Institutes’ Karina Davidson Appointed Chair of the U.S. Preventive Services Task Forceon April 12, 2021 at 5:55 am
“Prevention through screening, behavioral counseling and preventive medicine is the cornerstone of improving the health of people nationwide,” said Dr. Davidson, who is also dean of academic ...
via Bing News