Healthier lifestyles and better disease management led to a sharp drop in death rates for Americans with diabetes between 1997 and 2006, especially deaths caused by heart disease and stroke, a new federal government report shows.
During that time, deaths from all causes for Americans with diabetes fell by 23% and deaths caused by heart disease and stroke in this group declined by 40%, according to the analysis of 1997-2004 National Health Interview Survey data on nearly 250 000 adults.
One expert said the findings were reason for hope.
"The encouraging news that less diabetic patients are dying from heart disease and stroke is a testament to multiple factors that have changed the playing field," said Dr Tara Narula, a cardiologist at Lenox Hill Hospital in New York City.
Improvement in medical treatments
The study was conducted by researchers at the US Centres for Disease Control and Prevention and the US National Institutes of Health. They stressed that despite improvements in care, adults with diabetes are still more likely to die at a younger age than those without the disease. Nevertheless, the gap is narrowing, they said.
Contributing to the decline in death rates among people with diabetes were improved medical treatments for heart disease, better management of diabetes, better control of high blood pressure and high cholesterol, and healthy lifestyle changes among diabetes patients, who were less likely to smoke and more likely to be physically active than in the past.
Narula agreed, noting that improvements in drug therapy and control of risk factors have been key to keeping diabetic patients healthier for longer. Advances in the surgical care of heart disease have helped, too, she said.
"Finally, widespread educational campaigns about heart disease and diabetes have increased awareness in the general public and physician practice of how diabetes affects the cardiovascular system and the benefits of stricter blood sugar control," Narula said. All of these changes "have additive effects. So, while overall obesity and diabetes rates may be climbing, our approach to treating diabetics aggressively with medication, intervention and teaching has improved," she said.
Obesity in diabetics increase
However, Narula and the CDC researchers noted that obesity levels among people with diabetes continued to increase during the study period.
"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," Ann Albright, director of CDC's division of diabetes translation, said in a CDC news release. "Although the cardiovascular disease death rate for people with diabetes has dropped, it is still twice as high as for adults without diabetes."
The study was published in the journal Diabetes Care.
Previous research has found that rates of heart disease and stroke are declining for all US adults, and those rates are dropping faster for people with diabetes for those without diabetes.
Diabetes leading cause of kidney failure
Recent CDC studies also found that people with diabetes have declining rates of kidney failure, amputation of feet and legs, and hospitalization for heart disease and stroke.
The number of Americans diagnosed with diabetes has tripled since 1980. The CDC estimates that 25.8 million Americans currently have diabetes, but 7 million of them are not aware they have the disease.
In 2009, diabetes was the seventh leading cause of death in the United States, 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.
Medical costs for people with diabetes are more than twice as high as for people without diabetes. The estimated total costs of diabetes in the United States are R1, 4 trillion, including R956 in direct medical costs.
(HealthDay News May 2012)