Diabetes complications have plunged since 1990: CDC

Substantial declines have occurred during the past 20 years in the rates of five major diabetes-related complications, with the biggest drops seen in cardiovascular events, the CDC says in a new report. Although the nation has come a long way, the agency notes reason for concern still exists—the number of adults with the disease more than tripled during that time period.

The relative risk of the major complications from diabetes—heart attack, hyperglycemia, stroke, amputation and kidney failure—between 1990 and 2010 all declined, finds the new report published Tuesday.

“These findings probably reflect a combination of advances in acute clinical care, improvements in the performance of healthcare system and health promotion efforts directed at patients with diabetes,” study authors concluded.

The largest decline was seen in heart attack episodes, which dropped by about 60% during the past two decades; the smallest decline was in kidney failure, which dropped about 30%. The rate of strokes and of lower extremity amputations—in the upper and lower legs, ankles, feet and toes—declined by about half, the study showed.

The rate of stroke and heart attack are now comparable, given the substantial decline in rates of myocardial infarction. Declines in diabetes-related complications were especially great among people aged 75 and older.

Still the good news was tempered by other troubling findings. The number of adults diagnosed with diabetes more than tripled, increasing from 6.5 million in 1990 to 20.7 million in 2010. The report notes that the overall population of U.S. adults increased by about 27% during that time.

Also, in the case of end-stage renal disease, reductions in rates were smaller, and rates actually increased among older adults. The reasons why rates were so different for end-stage renal disease are not clear, though the Centers for Disease Control and Prevention said they may be related to the declines in heart disease.

“With declining mortality from cardiovascular disease, older patients with diabetes may have more years of life during which chronic kidney disease can progress to a point where dialysis or transplantation is needed,” the wrote.

The CDC used data from the National Health Interview Survey, the National Hospital Discharge Survey, the U.S. Renal Data System and the U.S. National Vital Statistics System to generate the findings. The agency accounted for changes in the size of the U.S. population to examine trends in the relative risk of complications.

The total cost of diagnosed diabetes, or Type 2, in the U.S. is about $245 billion a year, according to the American Diabetes Association, which released a report last year showing the cost of the disease increased 40% between 2007 and 2012. People diagnosed with the disease tend to spend 2.3 times more on medical expenses than those who do not have the condition.

“While the declines in complications are good news,” said Edward Gregg, a senior epidemiologist in CDC's division of diabetes translation and lead author of the new study, “they are still high and will stay with us unless we can make substantial progress in preventing Type 2 diabetes.”

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