Curbing The Over Treatment of T2D: Evidence Based Medicine May Help
To prevent the over treatment of individuals with type 2 diabetes a recent study suggests medical providers should follow the protocols of evidence-based medicine (EBM).
Over treatment, or the overuse of medical services leads to billions of dollars in wasteful U.S. healthcare spending, according to the National Academy of Medicine.
EBM is an individualized treatment strategy that incorporates the risks and benefits of medical services with the physician’s assessment, and the patient’s preferences. “When applied to type 2 diabetes, EBM calls for a paradigm shift in our treatment approach,” says Dr. Anil Makam, lead study author, and assistant professor of Internal Medicine at UT Southwestern.
The paradigm shift Makam mentions involves letting go of strict glucose management as a universal treatment goal for every type 2 diabetes patient. Older, more frail individuals, for instance, might be better served by aiming for modest glucose targets, such as A1C levels of 8.5 to 9 percent, instead of the usual 7 percent. Goals adjusted to meet EBM principles may ease the burden of diabetes treatment for many people, increasing their quality of life.
An integration of clinical expertise, patient values, and the best research evidence available informs EBM. Clinical expertise refers to a physician’s education, skills, and cumulated experience. To that expertise, patients add their unique preferences, concerns, expectations, and values, and science weighs in with data collected from sound clinical studies.
“EBM is often misunderstood as a call for universal, cookie-cutter medicine, which has led to an epidemic of over treatment in type 2 diabetes,” said researcher Dr. Oanh Nguyen. “Instead, EBM is a critical tool in the physician’s arsenal to provide individualized and person-centered care.”