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N. A. T. I. O. N. A. L. D. A. B. E. T. I. E. S. E. D. I. U. C. A. T. O. N. M. P. R. O. G. R. A. Changing the way diabetes is treated. Purpose of the Session. Update on NDEP activities Review accomplishments of race/ethnic work groups
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N A T I O N A L D A B E T I E S E D I U C A T O N M P R O G R A Changing the way diabetes is treated.
Purpose of the Session • Updateon NDEP activities • Reviewaccomplishments of race/ethnic work groups • Plansfor new comprehensive care campaign • Obtaininput 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 PWD Changing 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 together Changing 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 Network Community Interventions Health Systems
Comprehensive Diabetes Control Changing the way diabetes is treated
Risk Factors for Complications of Type 2 Diabetes NHANES III, 1991-1994 Percent 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
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 Changing the way diabetes is treated
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
Campaign Messages • 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. 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
Campaign Components • Educational materials • Mass media messages • Special populations tailored messages • Clinical tools • Participation of NDEP partner organizations Changing the way diabetes is treated
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./diabetes Changing the way diabetes is treated