Guest Family Physician Commentaries

The Journal of the American Board of Family Medicine

William J. Murdoch¹ 

[1] From the Wayne State University/Crittenton Family Medicine Residency, Rochester Hills, MI

关键词: Fever;    Arthritis;    Sore Throat;    Pharyngitis;    Adult-Onset Still Disease;    Case Report;   

DOI  :  10.3122/jabfm.2010.04.100113

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

The high prevalence and associated morbidity and mortality of type 2 diabetes mellitus (T2DM) present a significant challenge for today's family physician at the individual, patient, and public health levels. It follows that the primary and secondary prevention of this disease are of keen interest to clinicians. Kong et al¹ present data about the correlations between acanthosis nigricans (AN) and T2DM, replicating the findings from earlier, limited studies within a multistate primary care research consortium. The study highlights 2 key points that should be of interest to family physicians.

First, although AN was associated with a higher prevalence of T2DM, it did not relate well with the traditional screening modalities currently recommended for the disease. For example, AN showed no significant association with blood pressure, which is used by the US Preventive Services Task Force as the sole screening “trigger” for T2DM.² In addition, fasting blood glucose, currently the standard screening method, was also not correlated with AN. Several questions follow from these findings: Does the use of AN as a screening tool for T2DM present an opportunity to catch the disease process earlier? Would AN predict glycohemoglobin? And, most worrisome, are the current screening standards and methods not as useful as we believe?

Second, the article highlights the importance of a thorough physical examination performed by a knowledgeable clinician. The Continuing Medical Education program designed by the authors to train clinicians on the identification of AN³ would be a useful tool for all family physicians. Indeed, the low cost and noninvasive nature of this potential screening tool (if borne out by further research) would mandate increased education for all clinicians about the recognition and management of AN.

【 授权许可】

Unknown   

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