Diagnosis and management of cardiometabolic disease after spinal cord injury: Identifying gaps in physician training and practices

Cardiometabolic disease (CMD) is a major health concern for individuals with spinal cord injury (SCI). This study investigates how physicians screen for and manage CMD in SCI patients, comparing their practices to established SCI-specific guidelines. The survey revealed that while most physicians felt the ideal screening time was 6 months post-injury, few screened for insulin resistance and lipid dysregulation before this point. Many also felt uncomfortable prescribing related medications. The study found that VA-based physicians were more proactive in screening and managing CMD risk factors compared to non-VA physicians, suggesting that VA training models may be more effective.

• 1
  A significant portion of SCI medicine physicians believe the ideal timeframe for CMD screening is 6 months post-injury, which contrasts with guidelines recommending earlier assessment.
• 2
  There are gaps in screening practices, particularly for insulin resistance and lipid dysregulation, as well as discomfort in prescribing related medications among SCI physicians.
• 3
  VA-based providers are more likely to screen for CMD within 6 months of injury and are more comfortable managing/starting anti-glycemic medications and statins compared to non-VA providers.