June 2014

Studies: Diabetes Prevalence Is Up While Diabetes Complications Are Down

By Brian McCurdy, Senior Editor

Two recent studies offer bad news and good news about diabetes. One study tracks a continued rise in the incidence of diabetes and stability in the numbers of those with undiagnosed diabetes, and the other study notes a decrease in complications of the disease.

   A recent study in the Annals of Internal Medicine notes that over the last two decades, the prevalence of total confirmed diabetes has increased while the prevalence of undiagnosed diabetes remained fairly stable, thus reducing the proportion of total undiagnosed diabetes cases to 11 percent (of those estimated to have diabetes) from 2005 to 2010. Researchers say this suggests improvements in screening and diagnosis. The study adds that among the increasing population of those with diagnosed diabetes, glycemic control has improved but remains a challenge, particularly among non-Hispanic African Americans and Mexican Americans.

   Another study in the New England Journal of Medicine notes that preventive care for adults with diabetes has improved substantially from 1990 through 2010. Researchers measured declines in the rates of acute myocardial infarction, death from hyperglycemic crisis, stroke, lower extremity amputations and end-stage renal disease. Despite the decline in diabetes complications, the study notes that “a large burden of disease persists” due to the increased prevalence of the disease.

   Eric Jaakola, DPM, FACFAS, attributes the rise of diabetes to an exponential increase in population coupled with the rate of obesity in the United States and the direct relationship between obesity and diabetes. Barry Rosenblum, DPM, concurs that the rising incidence of obesity is a factor.

   As far as the decrease in diabetes complications goes, Dr. Jaakola says this may be because preventative medicine is on the rise and primary care physicians are instituting more protocols that address the complications of diabetes.

   Dr. Rosenblum calls the decrease in diabetes complications “a double-edged sword.

   “Better control of diabetes and overall management of the disease has certainly helped decrease the rate of complications,” says Dr. Rosenblum, the Associate Chief of Podiatry at the Beth Israel Deaconess Medical Center in Boston and an Assistant Clinical Professor of Surgery at Harvard Medical School. “However, the total number of complications continues to increase due to the larger number of patients diagnosed with diabetes.”

   What actions can physicians and patients take to both lower diabetes prevalence and continue to reduce the complications of diabetes? Both Dr. Jaakola and Dr. Rosenblum emphasize the importance of patient diet with Dr. Jaakola stressing the choices a patient makes and the education about food that a physician gives. He suggests that his patients eat food with one ingredient, such as chicken or broccoli, and stay away from foods with more than three ingredients. Patients should also see their doctors on a routine basis, not just when something is wrong, according to Dr. Jaakola, who is in private practice at the Diabetic Foot and Wound Center in Denver.

   Dr. Rosenblum adds that early diagnosis and control of blood sugar levels, once a physician has diagnosed diabetes, is a proven intervention that helps in reducing the risk of complications.

Vibram Settles Lawsuit Over Minimalist Shoes

By Brian McCurdy, Senior Editor

Following a class action lawsuit that its FiveFingers minimalist running shoes do not perform as advertised, Vibram USA recently agreed to a $3.75 million settlement.

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