Cardiovascular, Diabetes Complication Decline

Rates of heart attacks and strokes declined substantially in the past 20 years among US adults with diabetes, according to a study by the Centers for Disease Control and Prevention (CDC). Heart attack and stroke victims, especially those aged 75 and older, reported the greatest declines in diabetes-related complications.

Rates of other diabetes-related complications—lower-limb amputation, end-stage kidney failure, and deaths due to hyperglycemia—also declined. Cardiovascular complications and deaths from hyperglycemia decreased by more than 60% each, while rates of both strokes and amputations declined by about half, the CDC reported. Rates for end-stage kidney failure fell by about 30%.

“These findings show that we have come a long way in preventing complications and improving quality of life for people with diabetes,” Edward Gregg, PhD, a senior epidemiologist in CDC’s Division of Diabetes Translation and lead author of the study, said in a statement. “While the declines in complications are good news, they are still high and will stay with us unless we can make substantial progress in preventing type 2 diabetes.”

CDC researchers attribute the declines in diabetes-related complications to increased availability to healthcare services, risk factor control, and increased awareness of the risks associated with diabetes.

Because the number of adults with diabetes during this timeframe more than tripled from 6.5 million to 20.7 million, the healthcare system continues to face a large burden of disease. An additional 79 million have prediabetes and are at risk of developing the disease, according to the research. Each year, nearly $176 billion in total medical costs can be attributed to diabetes and its complications.

The data came from the National Health Interview Survey, the National Hospital Discharge Survey, the US Renal Data System, and the US National Vital Statistics System between 1990 and 2010 with age standardized to the US population in 2000.

The study was published in the New England Journal of Medicine (Gregg et al., 2014; volume 370, pages 1514-1523.