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Rates of Diabetic Heart Attacks and Strokes Fall 60%

Diabetes rate is increasing while diabetes-related complications are decreasing…. 

Over the past two decades, the rates of myocardial infarctions and strokes in diabetic patients has dropped by over 60% according to a recent study.

Researchers examined trends in the incidence of diabetes-related complications, between 1900 and 2010, by comparing the incidences of end-stage renal disease, acute myocardial infarction, lower-extremity amputation, and death due to hyperglycemic crisis. Sources of data included; the National Health Interview Survey, the National Hospital Discharge Survey, the U.S. Renal Data System, and the U.S. National Vital Statistics System.

Between 1990 and 2010, researchers found a decrease in incidence among all 5 diabetes-related complications. This was most apparent in acute myocardial infarction, (−67.8%; CI 95%, −76.2 to −59.3) and death from hyperglycemic crisis (−64.4%; CI 95%, −68.0 to −60.9). For acute myocardial infarction, this corresponds to an absolute decline of 95.6 fewer cases per 10,000 persons; 95% CI, 76.6 to 114.6). The incidence of stroke and lower-extremity amputations also decreased (−52.7% and −51.4%, respectively).

The smallest decline was in end-stage renal disease (−28.3%; CI 95%, −34.6 to −21.6) and the smallest absolute decline was seen in the number of deaths from hyperglycemic crisis (−2.7; CI 95%, −2.4 to −3.0).

This decline in diabetes-related complications may be attributed to better screening, medicines and diabetes-related care. With the number of diabetics more than tripling during this same time period, it’s safe to say initiatives for preventing diabetes-related complications are working. However, work still needs to be done to decrease the overall prevalence of diabetes.

Practice Pearls:
  • Diabetes-related complications may include end-stage renal disease, acute myocardial infarction, lower-extremity amputation and hyperglycemic crisis
  • The rates of major diabetes-related complications have significantly declined over the course of the past 2 decades due to comprehensive health care initiatives – however the prevalence of diabetes has continued to rise
  • A strong emphasis on diabetes prevention is still needed

Gregg EW, Li Y, Wang J, et al. Changes in Diabetes-Related Complications in the United States, 1990–2010. N Engl J Med. 2014;370(16):1514-1523. http://www.nejm.org/doi/pdf/10.1056/NEJMoa1310799