Prevent & Protect – Control Blood Sugar To Prevent Complications

Source: Diabetes Focus
July-September 2007

Control Blood Sugar To Prevent Diabetic Complications And Protect Your Health

THE FACTS SPEAK FOR THEMSELVES: Three out of five people with diabetes have one or more complications from the disease. Adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than people without diabetes (and 65 percent of those with diabetes will eventually die of heart disease). About 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage. Diabetes retinopathy causes 12,000 to 24,000 new cases of blindness each year. In the United States, more than 200,000 people a year die from all types of diabetic complications.

And now, because of the epidemic of type 2 diabetes sweeping the country (the rate of adult-onset type 2 diabetes has doubled in the past 25 years), the number of people who have complications with serious consequences can only be expected to rise.

“The doubling of new cases over the last 25 years is probably an under-estimate because many people who have diabetes don’t know it,” says Daniel Einhorn, M.D., secretary of the board of directors of the American Association of Clinical Endocrinologists (AACE). “We currently assume that at least 20 million Americans have diabetes and the vast majority of them, about 95 percent, have type 2.”

For those already diagnosed with type 1, there is some good news. The Diabetes Control and Complications Trial (DCCT) found that those with type 1 who maintain intensive glucose control are at a significantly lower risk of developing complications: Their risk of eye disease was slashed by 76 percent; kidney disease, 50 percent; and nerve disease, 60 percent.

People with type 2 can take heart, too. Data from the UK Prospective Diabetes Study found that those who kept their blood sugar levels in the low to mid-100s over 10 years reduced, by 12 percent, complications related to diabetes, such as cardiovascular, peripheral vascular, eye and kidney disease. Plus, this group had 10 percent fewer diabetes-related deaths, including deaths from heart attack and stroke, and 6 percent lower mortality from all causes.

COMPLICATIONS ON THE RISE

In April, the AACE joined with the Amputee Coalition of America, Mended Hearts, the National Federation of the Blind and the National Kidney Foundation to issue a report, “The State of Diabetes Complications in America.” This report used data compiled from the National Health and Nutrition Examination Survey from 1999 to 2004 and from the Medical Expenditure Panel Survey in 2000, 2002 and 2004. Its findings include a wide range of statistics showing that complications are on the rise.

“We want to sound the alarm because we have the tools to help prevent high blood sugars, and that means we can help prevent and lower the risk of diabetic complications,” says Dr. Einhorn. “What is remarkable about this report is that despite knowing this and having the tools to control blood glucose, so many more people are developing complications.” Some key points of the report:

Kidney Failure: Diabetes is the most common cause of kidney failure, accounting for 44 percent of new kidney patients in 2002. People with diabetes are around 4.5 times more likely to develop chronic kidney disease than those without the condition.

Retinopathy and Eye Disease: Diabetes is the leading cause of new onset of blindness in adults ages 20 to 74. Between 40 to 45 percent of those with diagnosed diabetes have some eye damage because of the disease.

Cardiovascular and Heart Disease: Someone who has diabetes is nearly four times more likely to have a stroke, more than fives times more likely to have a heart attack and more than four times more likely to develop coronary artery disease than someone without the disease. “Every cardiologist will tell you that their diabetic patients simply don’t do as well as people who don’t have diabetes,” notes Dr. Einhorn.

Amputation: More than 60 percent of leg and foot amputations not related to injury occur in people with diabetes. Dr. Einhorn notes that even though comprehensive foot-care programs can reduce amputations by 45 to 85 percent, there were still about 82,000 amputations due to diabetes in 2002-the vast majority of which could have been prevented.

WHAT’S NEXT

“This is an extremely discouraging report on the state of diabetes complications in America,” remarks Paddy Rossbach, R.N., president and CEO of the Amputee Coalition of America. “Words, numbers and graphs can’t begin to describe the devastating effects they have on people’s lives-the individuals themselves, as well as their family members and caregivers. The thrust of this campaign is to make us all sit up and recognize the depth of these devastating complications.”