NAT I ONALDIABETES

DE ITACU ONP R OGR AM

Changing the way diabetes is treated.

Purpose of the Session

• Update on NDEP activities

• Review accomplishments of race/ethnic work groups

• Plans for new comprehensive care campaign

• Obtain input for future planning Changing

the way diabetes is treated

How is science driving NDEP activities?

• DCCT: Metabolic control matters.

Changing the way diabetes is treated

How has the science evolved?

• UKPDS: Blood pressure control matters

• 4S and West of Scotland: cholesterol control makes a difference

• Meta-analysis of aspirin data: aspirin therapy works for PWDChanging the

way diabetes is treated

How have practice guidelines changed?

• JNC VI

• ATP III

• ADA Clinical Guidelines

Changing the way diabetes is treated

We are changing the way diabetes is treated.

• DQIP

• AMA, JCAHO and NCQA

• AHA

• New therapies

• Major education campaigns

Changing the way diabetes is treated

NDEP Accomplishments

• Control Your Diabetes. For Life. campaign

• Educational materials

• Clinical tools

• Key partners working togetherChanging the

way diabetes is treated

We still need to bridge the gap.

Current Care Desired Care

5 Components of the NDEP

Awareness Campaigns

Special Populations

Partnership NetworkCommunity

InterventionsHealth Systems

Changing the Way Diabetes Is Treated

Comprehensive Diabetes Control

Changing the way diabetes is treated

Risk Factors for Complications of Type 2 Diabetes

58

36

63

51

28

4245

22

0

20

40

60

Percent

NHANES III, 1991-1994

Hba1c Albumin- Hyper LDL HDL Trigly- BMI Cigarette>7% uria tension>130 <35 glycerides >30 smoking

>200

The Good News:

People with diabetes can take steps to significantly reduce their risk of heart disease

Changing the way diabetes is treated

Changing the way diabetes is treated

The ABCs of Diabetes Control

A = A1C

B = Blood pressure

C = Cholesterol

Changing the way diabetes is treated

The Science Behind the ABCs of Diabetes

Control

Changing the way diabetes is treated

A1C

• DCCT: Intensive blood glucose therapy reduced risk of microvascular complications

• EDIC: Microvascular benefits endure

• EDIC: Intensive therapy reduced risk of atherosclerosis

Changing the way diabetes is treated

Blood Pressure

UKPDS• 10-point reduction in systolic

and 5-point reduction in diastolic blood pressure

• 21% decrease in heart attack risk

• 44% decrease in stroke risk

Changing the way diabetes is treated

Blood Pressure

Hypertension Optimal Treatment Study (HOT)

• Three diastolic goals: 80, 85, and 90

• 51% reduction in CV events at diastolic pressure of 80

Changing the way diabetes is treated

Controlling Blood Pressure in People with Diabetes

• ABCD and HOPE: effectiveness of ACE inhibitors

• HOPE: 25 - 30% reduction in risk of heart attack, stroke, or CV death

• UKPDS: beta blockers and ACE inhibitors worked equally well

Changing the way diabetes is treated

Controlling Cholesterol in People with Diabetes

• CARE: 25% reduction in heart attacks or CV deaths using statin therapy

• 4S significantly reduced CHD incidence with simvastatin

• NCEP: recommends LDL-cholesterol < 100 for people with diabetes

The Bottom Line:

• Aggressive control of blood glucose, blood pressure, and cholesterol can make a big difference in outcomes for people with diabetes.

Changing the way diabetes is treated

Be Smart About Your Heart Campaign Logo

Insert “Be Smart” campaign logo

• Diabetes is a key risk factor for CVD

• Rigorous control of blood glucose, blood pressure, and cholesterol helps prevent CVD and other diabetes complications.

• Move more, eat better, and take medications as prescribed, to feel better and enjoy a better quality of life.

Campaign Messages

Changing the way diabetes is treated

Campaign Messages

• What are my A1C, blood pressure and cholesterol numbers?

• What are my treatment goals?

• What do I need to do to reach my goals?

Changing the way diabetes is treated

Changing the way diabetes is treated

Campaign Components

• Educational materials • Mass media messages• Special populations tailored

messages• Clinical tools • Participation of NDEP partner

organizations

How can you help?

• Promote the ABCs of Diabetes to your patients and your colleagues

• Reinforce the physical activity and healthy eating messages

Changing the way diabetes is treated

Find out more:

• Call 1-800-438-5383 to order materials

• Call 1-877-232-3422 for Hispanic campaign materials

• Call 1-800-860-8747 to speak with a diabetes information specialist

• Visit the NDEP Web Sites

– http://ndep.nih.gov

– www.cdc.gov./diabetesChanging the way diabetes is treated