Diabetes-related complications show dramatic reduction

Efforts to combat diabetes and its resulting complications are paying off, according to a new study.

Researches from the Centers for Disease Control and Prevention (CDC) examined data from a variety of national sources between 1990 and 2010 for five diabetes-related complications: lower-extremity amputations, end-stage renal disease, acute myocardial infarction (MI), stroke, and death from hyperglycemic crisis. They found that:

• acute MIs declined by 67.8%,

• deaths from hyperglycemic crisis were down by 64.4%,

• the number of stroked declined by 52.7%,

• the number of amputations declined by 51.4%, and

• the number of incidents of end-stage renal disease declined by 28.3%

During the same period, however, the number of adults diagnosed with diabetes more than tripled, from 6.5 million to 20.7 million, and the annual numbers of amputations, cases of end-stage renal disease, and strokes have continued to grow. The nation’s adult population grew by 27% during the period studied.

Results of the study were published in the April 17, 2014 issue of The New England Journal of Medicine.  It was led by Edward W. Gregg, Ph.D., chief of the epidemiology and statistics branch, division of diabetes translation in the CDC.

The study’s authors say their findings “probably reflect a combination of advances in acute clinical care, improvements in the performance of the healthcare system, and health promotion efforts directed at patients with diabetes.”

The greatest declines in complications, in both absolute and relative terms, came among patients age 75 or older, so that by 2010 death rates from hyperglycemic crisis were actually higher among younger adults than among older adults.

The one exception to the improvement among the older age cohort was for end-stage renal disease, which also showed the smallest percentage decline in the number of incidents (28.3%). The authors say this may be due to the increase in the proportion of non-Hispanic blacks with diabetes, because the rate of end-stage renal disease among African-Americans is twice that of whites.

Data for the study came from the national Health Interview Survey, the National Hospital Discharge Survey, the U.S. Renal Data System, and the U.S. National Vital Statistics System.