Comprehensive diabetes treatment could save lives

Guidelines now lower for diabetics

A partnership of government agencies and other organizations has launched a new initiative aimed at reducing the mortality rates of people with diabetes.

The U.S. Department of Health and Human Services (HHS), the National Diabetes Education Program (NDEP), the American Diabetes Association, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Centers for Disease Control and Prevention issued new, lower guidelines for blood pressure and LDL cholesterol in people with diabetes. The guidelines recommend blood pressure and cholesterol levels in diabetics that are lower than those for the general population and similar to those for people with heart disease.

Research shows that 75% of people with diabetes die from heart disease and stroke, and they die younger than the general population. Additional research shows that people with diabetes can live longer and healthier lives with relative small decreases in blood glucose, blood pressure, and cholesterol.

The partners have launched a public awareness campaign to demonstrate that good diabetes care encompasses more than just managing blood glucose levels. It also should include managing blood pressure and cholesterol levels to help prevent heart disease and stroke.

"With 16 million people and counting, diabetes is growing at an alarming rate in America, says Tommy Thompson, HHS Secretary.

He cited statistics that shows that diabetes has increased 49% from 1990 to 2000, and projections indicate a 165% increase by the year 2050.

Diabetics are at a very high risk for heart attack and stroke, he added.

To communicate the importance of comprehensive care in simple language, the "ABCs" of diabetes have been developed:

"A" stands for A1C, or hemoglobin A1C, test that measure average blood sugar over the previous three months.

"B" is for blood pressure.

"C" is for cholesterol.

"People with diabetes know how important it is to control their blood glucose, but too little attention is paid to the role of cholesterol and blood pressure," says Allen M. Spiegel, MD, NDEP spokesperson and director of the NIDDK at the National Institutes of Health (NIH). "Research shows that this new approach, aggressively treating these three risk factors, can save lives, " he adds.

The new recommended targets for diabetics are:

  • A1C — less than 7%. Check at least twice a year.
  • Blood pressure — below 130/80. Check at every doctor’s visit.
  • Cholesterol (LDL) — below 100. Check at least once a year.

"The ABCs of diabetes is a clear message for both patients and health care providers that it’s not just glucose that matters if you want to help prevent heart disease and stroke," says John Buse, MD, chair of the American Diabetes Association’s Cardiovascular Initiative, titled "Make the Link."

NDEP and ADA have developed a new tool: A new brochure for people with diabetes that provides essential information and has a wallet card to help them track their ABC numbers. For more information, visit the NDEP’s web site at ndep.nih.gov or the ADA web site at www.diabetes.org/makethelink.