Death rates for people with diabetes dropped substantially from 1997 to 2006, especially deaths related to heart disease and stroke, according to researchers at the Centers for Disease Control and Prevention and the National Institutes of Health.
Deaths from all causes declined by 23 percent, and deaths related to heart disease and stroke dropped by 40 percent, according to the study published recently in the journal Diabetes Care. Scientists evaluated 1997-2004 National Health Interview Survey data from nearly 250,000 adults who were linked to the National Death Index. Although adults with diabetes still are more likely to die younger than those who do not have the disease, the gap is narrowing.
Improved medical treatment for cardiovascular disease, better management of diabetes, and some healthy lifestyle changes contributed to the decline. People with diabetes were less likely to smoke and more likely to be physically active than in the past. Better control of high blood pressure and high cholesterol also may have contributed to improved health. However, obesity levels among people with diabetes continued to increase.
“Taking care of your heart through healthy lifestyle choices is making a difference, but Americans continue to die from a disease that can be prevented,” said Ann Albright, Ph.D., R.D., director of CDC’s Division of Diabetes Translation. “Although the cardiovascular disease death rate for people with diabetes has dropped, it is still twice as high as for adults without diabetes.”
Previous studies have found that rates of heart disease and stroke are declining for all U.S. adults. Those rates are dropping faster for people with diabetes compared to adults without diabetes. Recent CDC studies also have found declining rates of kidney failure, amputation of feet and legs, and hospitalization for heart disease and stroke among people with diabetes.
Because people with diabetes are living longer and the rate of new cases being diagnosed is increasing, scientists expect the total number of people with the disease will continue to rise. The number of Americans diagnosed with diabetes has more than tripled since 1980, primarily due to type 2 diabetes, which is closely linked to a rise in obesity, inactivity and older age. CDC estimates that 25.8 million Americans have diabetes, and 7 million of them do not know they have the disease.
CDC and its partners are working on a variety of initiatives to prevent type 2 diabetes and to reduce its complications. CDC leads the National Diabetes Prevention Program, a public-private partnership designed to bring evidence-based programs for preventing type 2 diabetes to communities. The program supports establishing a network of lifestyle-change classes for overweight or obese people at high risk of developing type 2 diabetes.
“Diabetes carries significant personal and financial costs for individuals, their families, and the health care systems that treat them,” said Edward W. Gregg, Ph.D., the study’s lead author and chief of epidemiology and statistics in CDC’s Division of Diabetes Translation. “As the number of people with diabetes increases, it will be more important than ever to manage the disease to reduce complications and premature deaths.”
Controlling levels of blood sugar (glucose), cholesterol and blood pressure helps people with diabetes reduce the chance of developing serious complications, including heart disease, stroke, blindness and kidney disease.
In 2001, the National Diabetes Education Program (NDEP), a joint effort of CDC and NIH with the support of more than 200 partners, developed a campaign to raise awareness of the link between diabetes and heart disease and reinforce the importance of a comprehensive diabetes care plan that focuses on the ABCs of diabetes – A1C (a measure of blood glucose control over a two- to three-month period), Blood pressure and Cholesterol.
Last year CDC and the Centers for Medicare & Medicaid Services launched Million Hearts, an initiative to prevent 1 million heart attacks and strokes over the next five years. The initiative focuses on two main goals: empowering Americans to make healthy choices and improving care for people, focusing on aspirin for people at risk, blood pressure control, cholesterol management and smoking cessation. More than 2 million heart attacks and strokes occur every year, and treatment for these conditions and other vascular diseases account for about 1 of every 6 health care dollars. Up to 20 percent of deaths from heart attack and 13 percent of deaths from stroke are attributable to diabetes or prediabetes.
Diabetes was the seventh leading cause of death in 2009 and is the leading cause of new cases of kidney failure, blindness among adults younger than 75, and amputation of feet and legs not related to injury. People with diagnosed diabetes have medical costs that are more than twice as high as for people without the disease. The total costs of diabetes are an estimated $174 billion annually, including $116 billion in direct medical costs.