Considerable decrease in heart disease– and stroke-related deaths for people with diabetes

Data from the 1997–2004 National Health Interview Survey show that deaths related to heart disease and stroke decreased by 40%.

From 1997 to 2006, mortality rates for people with diabetes declined considerably, especially heart disease– and stroke-related deaths, reported CDC and the National Institutes of Health (NIH).

Data from the 1997–2004 National Health Interview Survey for 250,000 adults who were linked to the National Death Index were analyzed in a study published in Diabetes Care. CDC and NIH noted that among patients with diabetes, deaths from all causes decreased by 23% and deaths related to heart disease and stroke by 40%. CDC reported in a news release that "[a]lthough adults with diabetes still are more likely to die younger than those who do not have the disease, the gap is narrowing."

Factors leading to the decline in mortality include improved medical therapy for cardiovascular disease, improved diabetes management, and better lifestyle compared with in the past—people with diabetes are smoking less and increasing physical activity. CDC also noted that improved blood pressure and cholesterol control may have contributed to the improvement but that obesity levels among people with diabetes are still increasing.

Evidence has indicated that rates for heart disease and stroke are decreasing for all U.S. adults, but CDC reported that rates are lowering more quickly for people with compared with those without diabetes. Other CDC research shows that rates for kidney failure, amputation of feet and legs, and hospitalization for heart disease and stroke among people with diabetes are all on the decline.

The total number of people with diabetes is expected to continue to increase, however, because people with the disease are living longer and the diagnosis rate for new cases is increasing. CDC reported that since 1980, the number of Americans diagnosed with diabetes has "more than tripled," primarily because of type 2 diabetes, which is strongly tied to jumps in obesity, inactivity, and older age. Current estimates are that 25.8 million Americans have diabetes, 7 million of whom are not aware that they have the disease.

Campaigns to prevent diabetes and lower its complications include the following:

Project IMPACT: Diabetes. Project IMPACT (Improving America’s Communities Together): Diabetes is a national initiative that aims to improve care for patients with diabetes through community-based interdisciplinary teams that include pharmacists. The project is supported by the Bristol-Myers Squibb Foundation and focuses on improving the care of patients who are disproportionately affected by diabetes in 25 communities throughout the United States.

National Diabetes Prevention Program. This CDC-led, public–private partnership works to deliver evidence-based programs for preventing type 2 diabetes to communities. Establishing lifestyle change classes for overweight or obese people at high risk of developing type 2 diabetes is a major component of the program.

National Diabetes Education Program (NDEP). Spearheaded by CDC and NIH and with the support of more than 200 partners, NDEP works to raise awareness of the association between diabetes and heart disease and reinforce the importance of a comprehensive diabetes care plan. The programs includes encouraging patients to remain vigilant in their control of the ABCs of diabetes [http://ndep.nih.gov/i-have-diabetes/KnowYourABCs.aspx]: A1C (glycosylated hemoglobin), blood pressure, and cholesterol.

Million Hearts. Preventing 1 million heart attacks and strokes during the next 5 years is the goal of this CDC- and CMS-led initiative. Its two primary goals are (1) empowering Americans to make healthy choices and (2) improving care for people (with a focus on aspirin therapy for at-risk patients, blood pressure control, cholesterol management, and smoking cessation).

CDC also reported the following in its new release: "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."