The practice of prevention is always changing. It is a sign of strength that we can identify problems within our practices, and a justification of the confidence of our patients that we can correct those problems. Although expert recommendations flourish, it is essential for primary care physicians to examine all the elements of screening programs to ensure that the evidence demonstrates both effective and efficient care delivery. Diabetes preventive care now also entails close control of hypertension and cholesterol, periodic foot and eye examinations, and microalbumin testing.
Recognizing these new demands, the American Diabetes Association has recently announced the initiation of the Diabetic Cardiovascular Disease Initiative to emphasize the importance of cardiovascular disease prevention, and the American Medical Association, the National Council on Quality Assurance, and the Joint Commission on Health Care Accreditation have announced new performance measures for diabetes care that include a wide variety of important disease prevention practices.10 Family physicians, perhaps more than any other specialty, are continuing to discover better ways to deliver preventive care effectively and efficiently to our patients with diabetes.