Download Diabetes: Media Factsheet

 Diabetes: Media Factsheet
Overview
Diabetes is a life-long and progressive disease characterized by high blood sugar levels, often
referred to as hyperglycemia. Symptoms of diabetes may include frequent urination, thirst, vision
changes and fatigue.1
Diabetes occurs when the body either fails to produce enough of a hormone known as insulin, or it
cannot effectively use the insulin produced.2 Insulin, which is made in the pancreas, is released
upon food intake to help the body to use or store the glucose it gets from food, and thereby acts to
lower blood glucose levels.2
Key Facts





In 2011, the total US prevalence of diagnosed diabetes was estimated at 20.8 million adults
aged 18 years or older.3
Type 2 diabetes is the most common form of diabetes in adults, accounting for
approximately 90 to 95% of all diagnosed cases in the U.S.2
Diabetes is the 7th leading cause of death in the U.S., behind heart disease, cancer,
chronic lower respiratory diseases, stroke, unintentional injuries and Alzheimer’s
disease.2,4
The total estimated cost of diagnosed diabetes in 2012 was $245 billion dollars.5
Medical expenses for people with diabetes are more than two times higher than for
people without diabetes.2
Diabetes Classification


Type 1 diabetes is an auto-immune disease, which results in the destruction of the insulinproducing cells in the body, ultimately leading to a lack of insulin. Type 1 diabetes usually
develops during childhood or adolescence. There is no known way to prevent type 1
diabetes, and patients require lifelong insulin injections.2
Type 2 diabetes is a disease that results when the body does not use insulin properly, a
condition known as insulin resistance. As the need for insulin rises, the pancreas gradually
losing its ability to produce insulin.2 Type 2 diabetes was once thought to occur
predominantly in adults but is now also observed in younger patients.6 A lack of physical
activity, being overweight, increasing age, high blood pressure and genetics are known risk
factors that can contribute to the development of this form of diabetes.1 Type 2 diabetes is a
preventable condition.2 Treatment options include lifestyle changes, such as increased
physical activity and diet and at later stages may require the addition of oral and injectable
medications to manage blood sugar levels.1
Complications Associated With Diabetes
Patients with diabetes can suffer from a number of long-term health problems. These complications
are the result of consistently high blood sugar levels that over time can damage organs and other
parts of the body.2 It is these secondary complications that make up the main burden for patients
with diabetes.5
1 Diabetes: Media Factsheet
Diabetes is a leading cause of:
 Cardiovascular diseases – Adults with diabetes have heart disease death rates about two
to four times higher than adults without diabetes.2

Blindness – Diabetes is the leading cause of new cases of blindness in adults aged 20-74.2

Kidney failure – Diabetes accounted for 44% of all new cases of kidney failure in 2008.2

Nerve damage – Approximately 60% to 70% of people with diabetes have mild to severe
nerve damage.2
Treatment Options – Type 2 Diabetes
Based on a 1999 prospective study evaluating how often patients can achieve glycemic control
targets from various treatments, approximately 50% of type 2 diabetes patients originally controlled
with a single drug require the addition of a second drug after three years. After nine years,
approximately 75% of patients need multiple therapies to achieve adequate glucose control.7
The goal of diabetes treatments is to achieve as close-to-normal blood glucose levels as possible.
While guidance for actual treatment goals may vary and may need to be adjusted according to
patient needs, most guidelines advise on target HbA1c values below 7%.8 Physicians can assess
whether this treatment goal is met through the measurement of HbA1c levels, a parameter
indicative of the average amount of blood glucose in the body over the course of three months.9
Across all stages of type 2 diabetes management, diet, exercise and education remain at the
foundation of treatment programs.8
First-line therapy for patients generally involves treatment with metformin, an oral drug that works to
lower blood glucose levels by reducing the production of glucose by the liver and increasing insulin
sensitivity. The next step is often the addition of other oral medicines, such as sulfonylureas,
thiazolidinediones or DPP-4 inhibitors, which actively work to lower blood glucose levels by
increasing the amount of insulin released by the body or enhance insulin sensitivity. If combinations
of these oral medications are not effective in managing the patient’s disease, an injectable treatment
option such as a GLP-1 agonist, which stimulates insulin secretion in response to meal intake, or
basal insulin, may be added. Patients who are unable to achieve and maintain blood glucose goals
on basal insulin in combination with oral antidiabetic medications may require the addition of a GLP1 agonist or a more complex insulin therapy, including mealtime (prandial) insulin, to their treatment
regimen.8 It is estimated that over a period of 5 years, approximately 30% of patients with type 2
diabetes were using insulin as part of their treatment regimen.10,11 However, a stigma exists with this
course of treatment, and patients may associate it with failure of self-care, loss of independence,
weight gain and fear frequent injections, creating a need for alternative options.12
2 Diabetes: Media Factsheet
Patient-Centered Management
The American Diabetes Association (ADA) recommends a patient-centered approach to type 2
diabetes management that puts individual patient needs and specific disease characteristics and
constraints at the core of a comprehensive management and treatment plan. This shift towards
more patient-centered care is supported by evidence that this approach is effective and may
enhance adherence to therapy. 8,13,14
The ADA has issued recommendations for diabetes management, including:8,14
 Diet, exercise and education remain the foundation of any type 2 diabetes treatment
program
 Glycemic targets and glucose-lowering therapies must be individualized
 Comprehensive cardiovascular risk reduction must be a major focus of therapy
3 Diabetes: Media Factsheet
References
1
Centers for Disease Control and Prevention. Diabetes Public Health Resource: Basis About Diabetes.
Available at: http://www.cdc.gov/diabetes/consumer/learn.htm. Last accessed March 2014.
2 Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general
information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: U.S. Department of Health and
Human Services, Centers for Disease Control and Prevention, 2011. Available at
http://www.cdc.gov/diabetes/pubs/factsheet11.htm. Last accessed March 2014.
3 Centers for Disease Control and Prevention. Diabetes Public Health Resource – Number (in Millions) of Civilian,
Noninstitutionalized Adults with Diagnosed Diabetes, United States, 1980-2011. Available at:
http://www.cdc.gov/diabetes/statistics/prev/national/figadults.htm. Last accessed March 2014.
4 Centers for Disease Control and Prevention. FastStats- Leading Causes of Death, 2010. Available at:
http://www.cdc.gov/nchs/fastats/lcod.htm. Last accessed March 2014.
5 American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36:1033–
1046. Available at: http://care.diabetesjournals.org/content/36/4/1033.full.pdf+html. Last accessed March 2014.
6 American Diabetes Association. Type 2 Diabetes in the Young: The Evolving Epidemic. Diabetes Care.
2004;27: 1798-1811. Available at http://care.diabetesjournals.org/content/27/7/1798.full.pdf+html. Last
accessed March 2014.
7 Turner RC, Cull CA, Frighi V, Holman RR, Glycemic control with diet, sulfonylurea, metformin, or insulin in
patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK
Prospective Diabetes Study (UKPDS) Group. JAMA. 1999;281(21):2005.
8 Inzucchi S et al. Management of hyperglycemia in type 2 diabetes: A patient-centered approach. Diabetes
Care, 2012; 35:1364-79.
9 Perry RC. HbA1c measurement improves the detection of type 2 diabetes in high-risk individuals with
nondiagnostic levels of fasting plasma glucose: the Early Diabetes Intervention Program (EDIP). Diabetes Care
2001; 24:465-471. Available at http://care.diabetesjournals.org/content/24/3/465.long. Last accessed March
2014.
10 Mayfield JA, et al. Insulin therapy for type 2 diabetes: rescue, augmentation, and replacement of beta cell
function. Am Fam Physician. 2004; 70(3):489-500.
11 Koro CE, et al. Glycemic control from 1988 to 2000 among U.S. adults diagnosed with type 2 diabetes: a
preliminary report. Diabetes Care. 2004;27:17-20.
12 Minze MG, et al. Removing barriers to insulin use. Family Practice. 2011;60(10):577-580
13 Shah ND, Mullan RJ, Breslin M, Yawn BP, Ting HH, Montori VM. Translating comparative effectiveness into
practice: the case of diabetes medications. Med Care 2010;48(Suppl.):S153–S158.
14 American Diabetes Association. Standars of Medical Care in Diabetes – 2014. Available at
http://care.diabetesjournals.org/content/37/Supplement_1/S14.extract. Last accessed March 2014. 4