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New CDC Data Show Declines in Diabetes-Related Complications Among U.S. Adults

Health care system still bears heavy burden

Rates of five major diabetes-related complications have declined substantially in the last 20 years among U.S. adults with diabetes, according to a new study by the Centers for Disease Control and Prevention, published in the current issue of the New England Journal of Medicine.

Rates of lower-limb amputation, end-stage kidney failure, heart attack, stroke, and deaths due to hyperglycemia all declined. Cardiovascular complications and deaths from hyperglycemia decreased by more than 60% each, whereas the rates of both strokes and lower-extremity amputations — including the upper and lower legs, ankles, feet, and toes — declined by about half. Rates for end-stage kidney failure fell by about 30%.

However, because the number of adults reporting diabetes during this time frame more than tripled (from 6.5 million to 20.7 million), these major diabetes complications continue to put a heavy burden on the U.S. health care system, the report says. Nearly 26 million Americans have diabetes, and an additional 79 million have prediabetes and are at risk of developing the disease. Diabetes and its complications account for $176 billion in total medical costs each year.

CDC researchers used data from the National Health Interview Survey, the National Hospital Discharge Survey, the U.S. Renal Data System, and Vital Statistics to examine trends in the occurrence of diabetes-related complications in the U.S. between 1990 and 2010.

Although all complications declined, the greatest declines in diabetes-related complications occurred for heart attack and stroke, particularly among people 75 years of age and older. The authors attribute the declines in diabetes-related complications to increased availability of health care services, to risk factor control, and to increased awareness of the potential complications of diabetes.

Sources: NEJM; April 17, 2014; and CDC; April 16, 2014.

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