Medical Students' Knowledge of Diabetes Not Up-to-Date

The online version of the journal Diabetes Care is reporting (ahead of the published version) on medical student knowledge of inpatient diabetes among fourth year medical students. Unfortunately, their results do not paint a very favorable picture of medical training. The importance of proper management of inpatient hyperglycemia is increasingly being recognized, as patient outcomes are overwhelmingly better when blood glucose levels are managed intensively, and this has been validated by several different studies. For example, recoveries from surgery are shorter among patients with diabetes whose glucose levels are managed intensively, while the incidence of adverse events is generally lower. Yet the curriculum for 4th year medical students has consistently lagged behind current clinical recommendations.

In this most recent study conducted by the University of Florida Division of Endocrinology in Gainesville, sub-interns were given a pre-test on inpatient diabetes during the 2005-2006 school-year. The medical students frequently recommended the sole use of a sliding scale for insulin in the management of diabetes (a treatment that some prominent experts in the field believe should be abandoned), and the students were less likely to recognize hyperglycemia in patients who were not known to have diabetes. While medical students had good knowledge about the recognition of the type of diabetes, and about the pharmacology of various medications, they were generally more likely to give appropriate management for chest pain than for diabetes.

The authors conclude that their study demonstrates the gaps in knowledge about inpatient diabetes that exist prior to internship and residency. They also suggest that their findings can be used to design a curriculum appropriately targeted to the level of 4th year medical students. Lets hope more medical schools follow their recommendations!