The “Math-abet” Book The “Math-abet” Book By Terrence Bomar.
NATIONAL D I ABET ES DEI TACUON PROGRA M Changing the way diabetes is treated.
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Transcript of NATIONAL D I ABET ES DEI TACUON PROGRA M 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
5 Components of the NDEP
Awareness Campaigns
Special Populations
Partnership NetworkCommunity
InterventionsHealth Systems
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
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
• 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