July 18, 2000 Washington, DC--More than two dozen major studies show that health care providers and people with type 2 diabetes need to take early and aggressive action to reduce the disability and premature deaths from diabetes-related diseases. The July 19, 2000 commentary in the Journal of the American Medical Association (JAMA) includes this urgent message by the National Diabetes Education Program (NDEP), a joint initiative of the National Institutes of Health and the Centers for Disease Control and Prevention.
"Despite the availability of simple diagnostic tests, studies show that a person can have type 2 diabetes for 9 to 12 years before it is discovered," said Dr. Charles M. Clark, Jr., M.D., Chairman of the NDEP. During these years, harmful changes are already occurring, causing 15 to 20 percent of people to have eye damage and 5 to 10 percent to have kidney disease at the time of diagnosis.
Treating type 2 diabetes early is especially important. "We now know that blood glucose control appears to be most effective in preventing the onset of diabetes complications," stated Dr. Clark. "People who already have diabetes-related complications also clearly benefit from improved blood sugar control."
According to the NDEP's commentary, scientific evidence shows that improved blood sugar control provides both long-term benefits in reducing the risk or severity (more) of eye, kidney, and nerve complications, as well as more immediate short-term benefits. "When people with diabetes bring down their high blood sugar levels even by modest amounts, in just a matter of weeks, they feel better, have more energy, and lose fewer days of work," said Dr. Clark.
Despite the fact that aggressive diabetes management produces significant improvements in health outcomes, the latest national data show that more than half of people with diabetes in the United States have hemoglobin A1c (or A-1-C) levels above 7 percent, the level recommended as the goal for people with diabetes. Hemoglobin A1c testing is the best way to measure a person's average blood sugar level over the previous 3-month period. Yet, according to the commentary, the test is not being used widely in clinical practice to treat and manage diabetes.
Treating diabetes requires a plan to control blood pressure, blood cholesterol, and blood fats (or lipids), as well as blood sugar. All of these factors play a role in controlling diabetes and reducing risk of heart disease and stroke, the leading causes of death in people with diabetes. A proactive treatment plan should include defined goals and target levels for each of these factors and an action plan for achieving them.
For more information about controlling diabetes, call the National Diabetes Education Program at 1-800-438-5383 or visit the program's web sites at http://ndep.nih.gov or www.cdc.gov/diabetes on the Internet.
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The JAMA commentary was co-authored by Charles Clark, M.D., Judith Fradkin, M.D., Roland Hiss, M.D., Rodney Lorenz, M.D., Frank Vinicor, M.D., M.P.H., and Elizabeth Warren-Boulton, R.N., M.S.N. To obtain a copy of the commentary, Promoting Early Diagnosis and Treatment of Type 2 Diabetes: The National Diabetes Education Program, visit the JAMA web site at http://jama.ama-assn.org.
CONTACT:
Joanne Gallivan
(301) 496-3583, NIDDK, NIH
