Diabetes Care Still Lagging in U.S.

HEALTH DAY -- Diabetes care in the United States has improved in the last decade, but there is still a long way to go, according to a new report by researchers at the U.S. Centers for Disease Control and Prevention.

"There has been kind of a mixed message in the last five to seven years," said report co-author Dr. K. M. Venkat Narayan, chief of the CDC's Diabetes Epidemiology & Statistics Branch in the Division of Diabetes Translation. "There have been good improvements in some areas, which tell us it is possible to improve things, but there is still a job that is left undone."

The findings appear in the April 4 issue of the Annals of Internal Medicine.

There are 21 million people with diabetes in the United States and 41 million people who are in danger of becoming diabetic, Narayan said.

Acoording to the American Diabetes Association, about 5 percent of all diabetics have the familial, type 1 form of diabetes, caused by a dysfunction in the cells that produce insulin. The other 95 percent of cases are type 2 diabetes, which usually occurs in adulthood and is closely linked to obesity. In type 2 disease, the body either does not produce enough insulin, or the body's cells gradually lose sensitivity to insulin, causing a loss of control of blood sugar levels.

"What this report shows is that the application of good treatment to prevent complications in these people has improved in the last five to 10 years," he added.

Over the past 10 years, control of cholesterol among diabetics has improved substantially. There have also been small improvements in blood sugar control and yearly eye and foot examinations, all important components of the regular care of diabetics.

"The discouraging news is that blood pressure control and blood sugar control have remained fairly constant," Narayan said. "It has not changed in the last five to seven years."

In addition, two in five people with diabetes have poor control of their cholesterol, one in three has poor blood-pressure control, and one in five has poor control of blood-sugar levels, Narayan said.

"There are good treatments available, which can prevent a lot of long-term complications, such as cardiovascular disease, heart attacks, stroke, kidney disease, amputations and blindness," Narayan said.

He also noted there are many national programs aimed at preventing type 2 diabetes, as well as promoting better care for those with the disease. "Diabetes is a major cause of complications, unnecessary sickness and death, but applying what we know, a lot can be achieved. There has been a lot of positive improvement, but it's no time for being complacent," he said.