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US: Diabetes control worsened over the past decade (2007-2010 and 2015-2018 periods were worst)

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  • US: Diabetes control worsened over the past decade (2007-2010 and 2015-2018 periods were worst)
    June 29, 2021

    Diabetes control worsened over the past decade

    At a Glance
    • A study found that control over blood sugar and blood pressure has declined among people with diabetes after years of progress.
    • Uncontrolled diabetes increases the risk for serious health issues and could foreshadow growing complications among people with the disease.
    More than 34 million adults in the U.S. have diabetes. Diabetes occurs when blood sugar, also called blood glucose, is too high. Over time, if not well controlled, it can cause serious health problems such as heart disease, kidney failure, blindness, and limb amputation. Most people with diabetes have type 2, which is linked to lifestyle factors like weight and physical activity levels.

    Managing diabetes entails reducing high blood sugar, keeping it within a healthy range, and controlling blood pressure and cholesterol levels. Over the past two decades, new medications and treatment guidelines have expanded options for diabetes care.

    A research team led by Dr. Elizabeth Selvin of Johns Hopkins University examined trends in diabetes control and treatment from 1999 to 2018. They analyzed data from about 6,600 U.S. adults with diabetes who had participated in the CDC’s National Health and Nutrition Examination Survey. NHANES is a periodic survey of a representative sample of the U.S. population. Participants were 20 years of age or older, not pregnant, and had been diagnosed with diabetes by a physician.

    The study was funded by NIH’s National Heart, Lung, and Blood Institute (NHLBI). Results appeared in the New England Journal of Medicine, on June 10, 2021.

    The team found that blood sugar (glycemic) control declined between the 2007-2010 period and the 2015-2018 period from 57.4% to 50.5%. This decline was after more than a decade of progress in glycemic control starting in 1999.

    Blood pressure control showed a similar trend. After earlier progress, the percentage of among people with diabetes who had healthy blood pressure (<140/90 mm Hg) declined. From 2011–2014 to 2015–2018, blood pressure control decreased from 74.2% to 70.4% of the participants. This aligns with recent declines in blood pressure control among the general population...

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      SPECIAL REPORT-How the pandemic laid bare America's diabetes crisis
      by Reuters
      Thursday, 12 August 2021 10:59 GMT

      By Chad Terhune, Robin Respaut and Deborah J. Nelson

      WEST ALEXANDRIA, Ohio, Aug 12 (Reuters) - It took the deadly disruption of the COVID-19 pandemic to expose a deeper, more intractable U.S. public-health crisis: For more than a decade, the world's richest nation has been losing the battle against diabetes.

      Long before the pandemic, Kate Herrin was among the millions of Americans struggling to control their diabetes.

      Her problems often stemmed from her government-subsidized medical insurance. Doctors routinely rejected her Medicaid plan, and she repeatedly ran out of the test strips she needed to manage her daily insulin injections. She cycled in and out of emergency rooms with dangerously high blood-sugar levels, or hyperglycemia.

      Then COVID-19 hit. Herrin – poor and living alone – rarely left her apartment, ordering fast-food delivery instead of risking the grocery store. She stopped going in for regular lab tests. She had a harder time than ever securing medical supplies. Her health deteriorated further.

      On Dec. 15, Herrin and Elicia Heaston, her best friend, were swapping messages on Facebook midday when Herrin abruptly dropped off the conversation. Heaston called Herrin's phone and got no answer. When a few more hours passed without any word, Heaston and her husband drove from their home in rural West Alexandria, Ohio, to Herrin's apartment nearby and pounded on the door. No lights were on, but they could hear the television.

      Heaston called 911. When firefighters arrived, they found the 42-year-old dead on the bathroom floor. Herrin's rescue dogs, Honey and Sugar, were lying quietly next to her.

      The coroner attributed the heart attack that killed Herrin to complications of type 2 diabetes.

      "She was afraid COVID would kill her," Heaston said. "Instead, it isolated her, and her diabetes got worse. She didn't need to die at 42."

      COVID-19, which has killed more than 600,000 people in the United States, has had an especially devastating impact on the millions of Americans with diabetes. Health professionals and scientists noticed early on that many severely ill coronavirus patients also had the chronic disease. The U.S. Centers for Disease Control and Prevention (CDC) cites research showing that 40% or more of the people who died with COVID-19 also had diabetes.

      And those numbers don't reflect the damage the pandemic inflicted on diabetes patients who, like Herrin, never got sick from the virus but fell victim to the isolation and disruption it caused.

      Deaths from diabetes last year surged 17% to more than 100,000, based on a Reuters analysis of CDC data. Younger people – those ages 25 to 44 – suffered the sharpest increase, with a 29% jump in deaths. By comparison, all other deaths except those directly attributed to the coronavirus rose 6% last year, Reuters found.

      This grim toll is the result of a public-health failure that long predates the pandemic – and that is almost certain to persist after COVID-19 abates. After years of advances in treating diabetes, progress stalled about a decade ago. Since then, despite billions of dollars spent on new treatments, the prognosis for people with diabetes has been getting worse as the number of patients with the disease has increased, especially among working-age and even younger people.