The AAFP is lending support to legislation that would create a federal commission to focus on prevention and treatment of complex diseases.
The bill(www.congress.gov), sponsored by Pete Olson, R-Texas, and Dave Loebsack, D-Iowa, would create the National Clinical Care Commission. Its focus would be on improving prevention and treatment protocols for complex metabolic and autoimmune diseases, as well as those characterized by insulin resistance or insulin deficiency. The legislation has been passed by the House and referred to the Senate Committee on Health, Education, Labor and Pensions.
The AAFP sent the bill sponsors a letter dated Feb. 15(1 page PDF) that supports the measure, noting the work that family physicians do to assist patients with such ailments.
"Family physicians play a valuable role in the evidence-based prevention, early intervention and treatment for many of these patients," said the letter, which was signed by AAFP Board Chair Wanda Filer, M.D., M.B.A., of York, Pa. "We know the burden the disease can cause patients and their families."
The letter included some sobering statistics about the rise of complex chronic disease in the United States. There are 29 million Americans with diabetes, a staggering 9 percent of the population, the letter noted, and 27 percent of them are as yet undiagnosed. Further, 86 million Americans have insulin resistance or prediabetes.
"We are concerned about the growing number of patients diagnosed with diabetes and about the co-occurring conditions associated with metabolic conditions," the letter stated.
The proposed commission would include primary care physicians, other private citizens and government officials.
Initially, the commission was intended to focus on diabetes, but lawmakers broadened its scope to include other complex diseases. The AAFP suggested that the commission's mandate should be expanded even more to include studying patients with multiple chronic conditions and strategies for improving behavior change.
Regarding diabetes, the AAFP emphasizes a focus on prevention, recommending that adults ages 40 to 70 who are overweight or obese should be screened for abnormal levels of blood glucose and that patients who are considered at risk for diabetes should be counseled "to promote a healthful diet and physical activity."
In addition, the AAFP recommends that all adults and children age 6 years and older should be screened for obesity, and those who are diagnosed with the disease should be offered intensive behavioral interventions. In addition, a clinical practice guideline the AAFP has endorsed recommends that patients who are overweight or obese should be advised to participate for at least six months in a program that includes education on improving their diet and beginning an exercise routine.
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