Prediabetes presents puzzles in clinical practice

This issue covers the use of the term ‘prediabetes', non-VA care for veterans, and a wrap-up of ACP's Leadership Day.

The line “What's in a name?” is a famous quote from “Romeo and Juliet,” of course, but internists may increasingly find themselves asking that question in clinical practice, at least where glucose levels are concerned. The best way to manage “prediabetes,” or the state of impaired glucose tolerance that can precede diabetes development, is under some debate. On one hand, there are arguments in favor of labeling this predisease state as a way to better control it, while on the other, there are concerns about increased anxiety and other harms that may result. Our story in this issue looks at perspectives from several experts about keeping on top of changing glucose values and managing diabetes rates.

Approximately three-quarters of those who have served in the armed forces get some or all of their care at non-VA facilities, but physicians often don't know that their patients are veterans, which can have implications for care. Our story discusses why it's important to ask patients about military service, how when and where patients served can affect their health, and what resources are available for additional help and information.

This issue also features stories from ACP's annual Leadership Day, which was held in Washington, D.C., in May. Staff Writer Mollie Durkin's on-the-ground coverage of ACP members' visit to Capitol Hill and the Washington Perspective by Robert B. Doherty, ACP's Senior Vice President for Governmental Affairs and Public Policy explain how the event provides a perfect example of ACP advocacy in action.

For a roundup of what's new in hospital medicine, turn to our story that summarizes highlights from the Society of Hospital Medicine's annual meeting, held in Las Vegas in May. High-value care is the featured topic, encompassing general recommendations about explaining the concept to patients as well as specific tips on choosing an imaging test and caring for elderly patients. A feature story provides an update on state-of-the-art research involving type 1 diabetes and the “artificial pancreas,” while a Q&A offers details on new legislation that now allows certain pilots to seek medical clearance to fly from any state-licensed physician.

Do you use the term “prediabetes” when talking to patients? How many veterans do you care for in your practice? Let us know by emailing us.


Jennifer Kearney-Strouse
Executive Editor