Federal researchers on Wednesday reported the first broad national picture of progress against some of the most devastating complications of diabetes, which affects millions of Americans, finding that rates of heart attacks, strokes, kidney failure and amputations fell sharply over the past two decades. The biggest declines were in the rates of heart attacks and deaths from high blood sugar, which dropped by more than 60% from 1990 to 2010, the period studied. While researchers had had patchy indications that outcomes were improving for diabetic patients in recent years, the study, published in The New England Journal of Medicine, documents startling gains.
"This is the first really credible, reliable data that demonstrates that all of the efforts at reducing risk have paid off," said Dr David M Nathan, director of the Diabetes Center at Massachusetts General Hospital, who was not involved in the study. "Given that diabetes is the chronic epidemic of this millennium, this is a very important finding."
The number of Americans with diabetes more than tripled over the period of the study and is now nearly 26 million. Nearly all the increase came from Type 2 diabetes, which is often related to obesity and is the more common form of the disease. An additional 79 million Americans have pre-diabetes, which means they are at high risk of developing the disease.
Researchers from the Centers for Disease Control and Prevention, who wrote the study, estimate that diabetes and its complications account for about $176 billion in medical costs every year. The study measured outcomes for both Type 1 and Type 2.
Experts said the declines were the fruit of years of efforts to improve the health of patients with Type 2 diabetes. Doctors are much better now at controlling the risk factors that can lead to complications — for example, using medications to control blood sugar, cholesterol and blood pressure — health experts said. What is more, a widespread push to educate patients has improved how they look after themselves. And a major effort among health care providers to track the progress of diabetes patients and help steer the ones who are getting off track has started to have an effect. NYT NEWS SERVICE