A recently published study conducted by the Centers for Disease Control (CDC) indicates diabetes care improved during the past 10 years; however, there is still a great need to focus on additional improvements. A summary presented here looks at changes in glucose and cholesterol control, blood pressure, yearly eye and foot examinations, new national initiatives on quality care, and why we need to continually focus on effective treatment and preventive measures.

SUMMARY

Venkat Narayan, MD

Main Findings of the Study

Between the mid-1990s and now, there have been encouraging improvements in the quality of diabetes care. Gains have been identified in controlling cholesterol and somewhat in glucose control; in the use of aspirin, influenza and pneumococcal vaccines; and regular exams of eyes, feet, and teeth.
However, blood pressure (BP) control has not changed at all.
Despite the many improvements, 2 of 5 people with diabetes still have poor cholesterol control, 1 of 3 have poor BP control, 1 of 5 have poor glucose control.
Study results show that there are good treatments to prevent diabetes complications, and quality of care can be improved for the 14.6 million people in the United States who have diagnosed diabetes. Therefore, it is important that we not become complacent, but rather continue in our efforts to achieve further progress.

Why have improvements occurred?

This study did not specifically look at “why,” but a number of important developments have occurred during the last 5–10 years that together could account for the improvements.

Good science has become available to support and promote tight glucose, blood pressure, and lipid control for people with diabetes. CDC and National Institutes of Health (NIH) have invested in applied research aimed at promoting improvements in quality of care. More science is needed.
Several national initiatives to promote quality of diabetes care have been implemented.

The Alliance is a large coalition of government, managed care, and other players that emphasized quality of care and has developed ways to measure and track quality of care.
The CDC's Diabetes Prevention and Control Programs (DPCP) in all states has strongly emphasized and influenced improvements in diabetes quality of care.
The CDC and NIH have worked together in the National Diabetes Education Program (NDEP) to change the way diabetes is treated.
The Veteran’s Administration (VA) has undergone major reengineering aimed at improving quality of care.

Final messages

Twenty-one million people in the United States have diagnosed and undiagnosed diabetes. There are several good treatments for preventing diabetes complications. As this study shows, it is possible to improve the quality of care, but we still have a long way to go.

Forty-one million people in the United States have pre-diabetes, and can develop diabetes in the future. Preventing diabetes in these people is very important to reducing the pain and suffering from its devastating complications.

Citation

Saaddine B, Cadwell B, Gregg E, Engelglau M, Vinicor F, Imperatore G, Narayan V. Improvements in Diabetes Processes of Care and Intermediate Outcomes: United States, 1988-2002.* Ann Intern Med. 2006;465-474.

Affiliations: CDC's Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia, USA.

Full Article link: www.annals.org*

* Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.

Page Last Reviewed: July 12, 2007
Page last modified: August 31, 2006
Content Source: National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation

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