People With Diabetes Encouraged To Meet Goals

Lifestyle Change An Important Factor

Fewer than 12 percent of people with diagnosed diabetes meet the recommended goals for blood glucose, blood pressure, and cholesterol, says a new report in the Journal of the American Medical Association.

This news comes despite research showing that controlling these conditions dramatically delays or prevents diabetes complications.

“More diabetes patients are taking medication to control their blood pressure and cholesterol, but too few are making needed lifestyle changes such as exercising, lowering dietary fat, and losing weight to control the risk factors for diabetes complications,” says Dr. Catherine Cowie of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), one of the National Institutes of Health (NIH).

The researchers compared data obtained from a nationally representative sample of US adults age 20 years and older with diagnosed diabetes who took part in either the Third National Health and Nutrition Examination Survey (NHANES III) conducted from 1988 to 1994 or the NHANES conducted from 1999 to 2000.

Participants in the later survey, though similar in age and gender, were heavier, diagnosed with diabetes younger, and more likely to be using insulin along with oral drugs to treat their diabetes.

Only 37 percent (compared to 44 percent in the earlier NHANES) were achieving the American Diabetes Association’s goal for blood glucose control - a hemoglobin A1c (HbA1c) blood test result of less than 7 percent.

About 37 percent of participants in the later survey had HbA1c levels above 8 percent, ADA’s recommended “take action” level.

Although the percentage of people with diagnosed diabetes taking blood pressure medication has risen in the last decade, only 36 percent of participants in the most recent NHANES met ADA’s current blood pressure goal of less than 130/80 mm Hg, and 40 percent had high blood pressure.

More participants in the later survey were also receiving medication to lower high cholesterol, but 52 percent still had total cholesterol levels above 200 mg/dl.

The NHANES surveys did not ask participants which type of diabetes they had. According to the recently updated National Diabetes Statistics Fact Sheet, 18.2 million people - about 6 percent of the population - have diabetes.

Type 2 diabetes accounts for up to 95 percent of all diabetes cases. Most common in adults over age 40, this form of diabetes is strongly linked to obesity, inactivity, family history of diabetes, and racial or ethnic background.

Diabetes is the main cause of kidney failure, limb amputations, and new onset blindness in adults and is a major cause of heart disease and stroke.

Many clinical trials have proven that these complications can be dramatically reduced with good control of blood glucose, blood pressure, and cholesterol.

National campaigns such as the National Diabetes Education Program’s “Be Smart about your Heart. Control the ABCs of Diabetes” (HbA1c, Blood Pressure, and Cholesterol) have led to a wider awareness of the need to control the risk factors for diabetes complications.

But more needs to be done, the study’s authors conclude.

“We must redouble our efforts to empower patients and providers with information and tools to improve therapy and to provide incentives for the comprehensive care that has been proven effective in reducing diabetes complications,” said coauthor Dr. Judith Fradkin, director of NIDDK’s Diabetes, Endocrinology, and Metabolic Diseases Division.

Always consult your physician for more information.

Preventing High Blood Pressure

The American Diabetes Association recommends the following to help prevent the onset of high blood pressure:

Always consult your physician for more information.

Online Resources

American Diabetes Association

Centers for Disease Control and Prevention (CDC)

HealthierUS.Gov

National Diabetes Education Program

National Institute of Diabetes & Digestive & Kidney Diseases (NIDDKD)

National Insitutes of Health (NIH)

March 2004

People With Diabetes Encouraged To Meet Goals

Diabetes and Blood Pressure

Preventing High Blood Pressure

Online Resources

Other Resources:

Find a St. John's Mercy Physician

Diabetes Services at St. John's Mercy

Diabetes Health Information

St. John's Mercy Classes and Programs

Diabetes and Blood Pressure

High blood pressure is twice as likely to strike a person with diabetes than a person without diabetes.

Left untreated, high blood pressure can lead to increased risk for heart disease and stroke.

In fact, a person with diabetes and high blood pressure is four times as likely to develop heart disease than someone who does not have either of the conditions.

About 73 percent of adults with diabetes have blood pressure greater than or equal to 130/80 mm Hg or use prescription medications for hypertension.

Blood pressure is the force of the blood pushing against the artery walls. Each time the heart beats, it is pumping blood into these arteries - resulting in the highest blood pressure when the heart contracts and is pumping the blood.

High blood pressure, or hypertension, directly increases the risk of coronary heart disease (heart attack) and stroke (brain attack).

With high blood pressure, the arteries may have an increased resistance against the flow of blood, causing the heart to pump harder to circulate the blood.

Two numbers are used to measure blood pressure. The higher number, the systolic pressure, refers to the pressure inside the artery when the heart contracts and is pumping the blood through the body.

The lower number, the diastolic pressure, refers to the pressure inside the artery when the heart is at rest and is filling with blood. Both the systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury). This recording represents how high the mercury column is raised by the pressure of your blood.

According to the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), high blood pressure for adults is defined as:

and

In an update of NHLBI guidelines for hypertension in 2003, a new blood pressure category was added called prehypertension:

and

and

Often, persons with high blood pressure do not have noticeable symptoms. If the blood pressure is greatly elevated, an individual may experience the following. However, each individual may experience symptoms differently.

Always consult your physician for a diagnosis.