Preventing Chronic Diseases: Investing Wisely in Health
Preventing Diabetes and Its Complications
The Reality
Over 17 million Americans have diabetes, and about onethird of them dont know that they have the disease More than 200,000 people die each year with diabetesrelated complications Diabetes is now the sixth leading cause of death Diagnosed diabetes is projected to more than double by 2050 Type 2 diabetes, once believed to affect only adults, is being diagnosed increasingly among young people American Indians, African Americans, and Hispanics are about 2 to 3 times more likely than whites to have diabetes Diabetes is the leading cause of kidney failure and of new blindness in adults More than 60 of leg and foot amputations unrelated to injury are among people with diabetes Diabetes is a major cause of heart disease and stroke, which are responsible for about 65 of deaths among people with diabetes About 18,000 women with preexisting diabetes deliver babies each year, and 135,000 expectant mothers learn they have gestational diabetes Diabetes increases a womans risk for pregnancy complications and increases her childs risk for obesity and diabetes later in life
US
DEPARTMENT OF HEALTH AND HUMAN SERVICES
The Cost of Diabetes
The estimated economic cost of diabetes in 2002 was 132 billion Of this amount, 918 billion was due to direct medical costs and 398 billion to indirect costs such as lost workdays, restricted activity, and disability due to diabetes In 2002, the average medical expenditure for a person with diabetes was 13,243, or 24 times greater than the cost for a person without diabetes In 2002, 11 of national health care expenditures was for diabetes care
Diabetes Control Prevents Complications
Regular eye exams and timely treatment could prevent up to 90 of diabetes-related blindness Foot care programs that include regular examinations and patient education could prevent up to 85 of diabetesrelated amputations Treatment to better control blood pressure can reduce heart disease and stroke by 3350 and diabetes-related kidney failure by 33
Percentage of Adults With Diagnosed Diabetes Increased 61 From 1991 to 2001
1990
NJ MA VT CT DE MD NH RI
1996
CT DE MA MD NJ NH RI VT
2001
CT MA NH RI VT DE MD NJ
No data available
4
46
68
810
10
Includes women with a history of gestational diabetes Source: CDC, Behavioral Risk
Factor Surveillance System Revised April 2003
Diabetes Control: A Good Investment
Intensified blood pressure control can cut health care costs by 900 2000 US dollars over the lifetime of a person with type 2 diabetes It can also extend life by 6 months In just 5 years, a foot care program can save 900 2000 US dollars in health care costs for a person with diabetes who has had foot ulcers Such care prevents amputations Outpatient training to help people self-manage their diabetes prevents hospitalizations Every 1 invested in such training can cut health care costs by up to 876 Preconception care for women with diabetes leads to healthier mothers and babies Every 1 invested in such care can reduce health costs by up to 519 by preventing costly complications
Effective Strategies State Programs in Action
Minnesota Diabetes Control Program
Established in 1980, the Minnesota Diabetes Control Program MDCP has been a leader in reducing the impact of diabetes in Minnesota The MDCP and HealthPartners, a large Minnesota health plan, have developed a program called IDEAL Improving Diabetes Care Through Empowerment, Active Collaboration, and Leadership to improve the quality of diabetes
care at primary care clinics With IDEAL, they have achieved the following benefits for people with diabetes: Improvements in blood glucose tests: Patients A1C blood glucose levels dropped from 86 in 1994 to 74 in 1999; the A1C test measures the average level of glucose that has been in a patients blood over the last 3 months and shows if blood sugar is under control 7 or less or too high This decline represents a 75 achievement of the target goal of 7 and translates into a 40 reduction in complications that can lead to blindness, kidney failure, and amputation Improvements in cholesterol levels to reduce heartrelated complications: Bad cholesterol LDL, or lowdensity lipoprotein levels have dropped from 132 to 116, a 12 decrease, and good cholesterol HDL, or high-density lipoprotein levels have risen from 44 to 55, a 25 increase These changes can reduce heartrelated complications by as much as 50 Increases in preventive care medical exams: Increases have been documented in the percentage of patients having annual foot exams from 45 in 1994 to 90 in 1999, annual kidney function testing 0 to 82, and annual eye exams 27 to 60 These exams lead to the early detection and reduction of
costly complications such as blindness, kidney failure, and amputation Early detection, improved delivery of care, and better selfmanagement are key for preventing diabetes complications Here are several examples of these strategies in action: CDC, the Health Resources and Services Administration, and other federal partners have established the National Diabetes Collaborative to improve diabetes care by fostering excellence in federally funded health center systems Since 1999, over 270 health centers have adopted strategies to improve quality of care In the first year alone, over 60 of diabetes patients at these centers had the A1C blood glucose test twice a year, as recommended The A1C test is an effective tool for blood glucose control It detects problems early so that action can be taken to prevent disabling, costly complications By improving the quality of care and self-management practices of people with diabetes in an African American community in Raleigh, North Carolina, Project DIRECT Diabetes Intervention Reaching and Educating Communities Together increased the percentage of diabetes patients who received foot care counseling from 20 to 50 in its first year The project
has produced lasting improvements in home blood glucose monitoring, diabetes education, ophthalmology referrals, and vascular exams
Hope for the Future
Results from the Diabetes Prevention Program recently showed that a healthy diet and modest, consistent physical activity can cut a persons risk for developing type 2 diabetes by nearly 60 This is the first major study of Americans at high risk for type 2 diabetes to show that improving diet, increasing physical activity, and losing a little weight can prevent or delay the disease These scientific results give us real hope that we may ultimately stem the escalating epidemic of diabetes among Americans For more information or updates, visit wwwcdcgov/ nccdphp For additional copies of this document, E-mail ccdinfo@cdcgov
Source:hidaya.org
