Advancing diabetes treatment goals in Guatemala

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Dear friends,

Over the last few months since I last wrote a project update for our diabetes program, a lot of great things have happened!

As you know, for a number of years now we have focused on educational initiatives for our diabetic patients, coupled with intensive glucose-lowering strategies. One of the most rewarding parts of this initiative has been using glycosylated hemoglobin testing (“A1C” testing) to give us a better sense of how are patients are doing and how their medications should be adjusted. Using A1C as a target for treatment, about 50% of our patients now achieve a level of glucose control that we think is “excellent”, with another 25% achieving acceptable control (of course, with the other 25% still needing some work!

Now, in the last few months, we have been working to identify other areas where we can improve care for our diabetic patients. For example, since people with diabetes have a higher-than-average risk of heart disease, blood pressure control is very important. Although we have always treated high blood pressure in our diabetics, we are now being more aggressive in treating patients with more borderline high blood pressure readings, to reduce their risk of complications even further. This has been very successful, with more than 75% of our diabetics now reaching our goal for blood pressure control.

Finally, we have begun monitoring kidney function in our patients more aggressively. Long standing diabetes does permanent damage to the kidneys, and kidney disease in diabetes is a major cause of death and complications. Knowing whether a patient has kidney disease is tricky, because it means taking blood samples often in very rural settings, and transporting them to a central laboratory for analysis. However, thanks to several highly motivated staff members, we have been able to begin offering this service to our patients! Fortunately, only 10% of our patients have significant kidney disease; knowing this information, however, allows us to tailor our treatment for them in ways that better help to protect their kidneys.

Well, those are the updates for now! Thanks so much for your continued support!