Federal researchers Wednesday reported the first broad national picture of progress in combating some of the worst complications of diabetes, finding that rates of heart attacks, strokes, kidney failure and amputations fell sharply over the past two decades for the disease, which affects millions of Americans.
The biggest declines were in the rates of heart attacks and deaths from high blood sugar, which each dropped by more than 60 percent from 1990 to 2010, the period studied.
While researchers had patchy indications that outcomes were improving for diabetic patients in recent years, the study, published in The New England Journal of Medicine, documents surprising gains.
“Given that diabetes is the chronic epidemic of this millennium, this is a very important finding,” said Dr. David Nathan, director of the Diabetes Center at Massachusetts General Hospital, who was not involved in the study.
The number of Americans with diabetes more than tripled during the period of the study and is now nearly 26 million. Nearly all the increase came from Type 2 diabetes, which is often related to obesity and is the more common form of the disease. An additional 79 million Americans have pre-diabetes, which means they are at high risk of developing the disease.
Researchers said the declines were the fruit of years of efforts to improve the health of patients with Type 2 diabetes. Doctors are much better at controlling the risk factors that can lead to complications - for example, using medicine to control blood sugar, cholesterol and blood pressure - health experts said.
Additionally, a widespread push to educate patients has improved how they look after themselves. And a major effort among health-care providers to track the progress of diabetes patients and help steer the ones who are getting off track has started to have an effect.
Edward Gregg, a senior epidemiologist at the Centers for Disease Control and Prevention and the lead author of the study, said researchers used four federal data sets for a 20-year period to give the most comprehensive picture of diabetes outcomes.
He pointed out that heart attacks, which used to be the most common complication by far, had dropped down to the level of stroke, which also fell.
Front Section, Pages 4 on 04/17/2014