Yesterday, researchers from the Centers for Disease Control and Prevention published a report showing substantial progress over the past 20 years against some of the worst complications of diabetes, such as heart attacks, strokes, kidney failure and amputations. Rates of heart attacks and deaths from high blood sugar, for example, dropped by 60 percent from 1990 to 2010. The study, published in the New England Journal of Medicine, used four federal data sets including hundreds of thousands of patients, making it one of the largest such studies to date.
Elbert Huang, MD, associate professor of general internal medicine at the University of Chicago, said this is very good news for people living with diabetes.“The study is consistent with a number of studies showing major secular reductions in the rates of cardiovascular complications for the general population and for people with diabetes over the past three decades,” he said.
One of the biggest factors, Huang said, is that clinical management of diabetes has changed a great deal during this time. Most of the major clinical trials about glucose, blood pressure and cholesterol management were published in the 1990s, changing doctors’ understanding of how to treat the disease and manage complication. Widespread use of new treatments like statins, ACE inhibitors and aspirin also began during this time as well.
In January, Huang and his colleagues published a study in JAMA Internal Medicine that examined how rates of complications from diabetes change as people live longer with the disease. The irony is that as the medical community gets better at keeping diabetic patients healthier longer, new problems arise.
“There is an interesting twist to this story,” Huang said. “While rates of traditional complications of diabetes have declined, this means that other issues have risen to the surface as problems. Hypoglycemia has now emerged as a highly ranked problem. And as patients live longer with diabetes they begin to experience more geriatric problems.”
Despite the good news, however, Huang said that we’re still facing an unprecedented epidemic of obesity and diabetes, and the sheer numbers of people living with the disease are taxing the health care system. But as this week’s report points out, he said, “The actual experience of living with diabetes is better than it was 20 years ago.”