Drug Combo Could Lower Diabetes Complications and Costs
And, No-Cost, Noninvasive Tool Detects Risk for Undiagnosed Diabetes
Plus: Diabetes-Affected Pregnancies Double in Past Seven Years
ALEXANDRIA, Va., April 28 /PRNewswire-USNewswire/ -- A highly
detailed mathematical simulation model can help people with
undiagnosed diabetes identify whether they likely have the disease
and can predict ways for dramatically reducing the costs and
complications associated with this now epidemic illness, according
to studies being published April 28 in the May issue of Diabetes
Care.
The May issue also includes a study showing that diabetes, which
has been steadily rising in prevalence for decades, now affects an
alarming number of pregnancies in the United States.
Model Predicts Pill Combination Could Save Money and
Lives
Giving most people with diabetes an inexpensive combination of
medications could dramatically reduce the number of
diabetes-related complications and deaths in America and ultimately
save money, according to a highly detailed mathematical model
developed to simulate human physiology and health care
systems.
The Archimedes Model, originally developed by researchers at
Kaiser Permanente, was used to make predictions in three areas:
What would happen if diabetes were cured, if all people with
diabetes reached their treatment goals, or if the disease were
treated more aggressively?
Not surprisingly, curing diabetes would dramatically reduce the
risk of heart attacks in the United States (by 40 percent) and
prevent nearly 4.5 million deaths over a 30-year period. It would
also reduce health care costs by a whopping $444 billion over the
same period of time.
Absent a cure, providing optimal care -- bringing 100 percent of
those with diabetes to their treatment goals -- would save $325
billion in health costs and add 3.55 million life years to people
who have diabetes today. Adding a "polypill" to the usual care
given people with diabetes -- the most practical scenario analyzed
-- would cut the number of heart attacks in half, reduce eye
complications by a third and result in 10 percent fewer
diabetes-related deaths, the model found. Overall, giving an
inexpensive drug combination consisting of generic glucose,
cholesterol and blood pressure-lowering drugs along with low-dose
aspirin to all people with diabetes would result in 7.3 million
fewer serious complications over the next 30 years.
Diabetes continues to increase at an alarming rate in the U.S.
and around the world. Currently, about 10 percent of all American
adults and 20 percent of adults over the age of 60 have been
diagnosed with the disease. In 2007, Americans spent $174 billion
on type 1 and type 2 diabetes, including $58 billion in reduced
national productivity.
The Archimedes Model was used to see whether and how the human
and financial costs of this epidemic could be reduced. The authors
concluded that research for a cure should be made a national
priority and innovative solutions such as a polypill cocktail
should be pursued more aggressively.
"A world without diabetes and its complications is certainly
possible and the appropriate care for people with diabetes is
within our grasp," the authors wrote. "Both, however, require
unrelenting commitment and resolve."
Diabetes Risk Calculator Identifies Those Likely to Have
Diabetes
People who have diabetes and don't know it -- and those who have
a condition known as pre-diabetes -- will soon have access to a
free tool to assess their health status online. The Diabetes Risk
Test, based on a model developed by researchers at Archimedes,
Inc., a company that uses mathematical simulation models to address
healthcare problems, accurately assesses a person's chances of
having or developing undiagnosed diabetes or pre-diabetes, a
condition that often leads to diabetes.
The assessment tool, which will soon replace the American
Diabetes Association's existing online risk test, calculates a
person's chances of having diabetes using the answers to a series
of questions, such as age, weight, history of gestational diabetes
and other variables. The tool is intended to help people determine
if they should see a physician for further testing. It can be found
at www.diabetes.org/risktest.
"We know that the prevalence of diabetes continues to rise, and
that at least a quarter of people who have diabetes don't yet know
it," said David Eddy, lead researcher on the study and founder of
Archimedes, Inc. "But it's not cost effective or even efficient to
screen every single patient. This no-cost, easy-to-use tool can
help identify those people most likely to have diabetes or
pre-diabetes, so that they can receive the appropriate testing and
subsequent medical care."
The prevalence of diabetes has risen rapidly over the past
several decades. New guidelines from the ADA recommend screening
for diabetes among adults who are overweight or obese or who have
one or more risk factors for diabetes before the age of 45. For
those who have no risk factors, testing should begin at age
45.
The Diabetes Risk Test is the only currently available
noninvasive screening tool designed and scientifically validated to
detect both pre-diabetes and undiagnosed diabetes in the U.S.
population.
Increase in Diabetes Among Younger Women Affects More
Pregnancies
In less than seven years, the number of pregnant women giving
birth in a large managed health care plan who have type 1 or type 2
diabetes has more than doubled, leading to increased health risks
for both the mothers and their unborn children.
The increased prevalence of pre-existing diabetes among pregnant
women exists across all age groups and racial and ethnic
backgrounds. Because women are developing diabetes at younger ages,
the number of women affected during their early, reproductive years
has risen dramatically.
This study, by researchers at Kaiser Permanente in Southern
California, found the prevalence of pre-existing type 1 or type 2
diabetes among pregnant women doubled, from less than one (0.81)
out of 100 pregnancies in 1999 to close to two (1.82) out of 100
pregnancies in 2005. During the same period, the prevalence of
gestational diabetes (diabetes that develops during pregnancy and
then disappears after the baby is born) remained relatively
stable.
Both pre-existing diabetes and gestational diabetes have health
implications for mother and child that extend far beyond pregnancy.
However, for women with pre-existing diabetes, maternal
hyperglycemia that exists prior to pregnancy and continues into the
first 8 weeks of gestation exposes the fetus to an increased risk
of miscarriage and birth defects. Additionally, the earlier onset
and longer duration of maternal diabetes also suggests the women
may develop diabetes-related complications at an earlier age, the
researchers concluded.
Dr. Jean Lawrence, the lead author on this study, suggests that
"interventions that focus on reducing overweight and obesity can
help decrease the number of women who have diabetes during their
reproductive years. Given the increasing prevalence of diabetes in
childbearing-age women, the awareness that preconception care
reduces maternal and infant complications for women with diabetes
as well as the availability of these services becomes increasingly
important."
Diabetes Care, published by the American Diabetes Association,
is the leading peer-reviewed journal of clinical research into the
nation's fifth leading cause of death by disease. Diabetes also is
a leading cause of heart disease and stroke, as well as the leading
cause of adult blindness, kidney failure, and non-traumatic
amputations. For more information about diabetes, visit the
American Diabetes Association Web site www.diabetes.org or call
1-800-DIABETES (1-800-342-2383).
To reach lead author Dr. Robert A. Rizza, email
rizza.robert@mayo.edu or
phone: 507-255-6515.
To reach Dr. David Eddy, email author@archimedesmodel.com or
phone:
415-490-0408.
To reach Dr. Lawrence at Kaiser Permanente Southern California,
Research
and Development, email jean.m.lawrence@kp.org or phone:
626-564-3106. Or try
Danielle Cass, National Public Relations and Media Manager at
Kaiser,
510-267-5354, email: Danielle.x.cass@kp.org.
First Call Analyst:
FCMN Contact:
Source: American Diabetes Association
CONTACT: Sarah Bradley of ADA, +1-703-549-1500 ext.
2231
Web Site: http://www.diabetes.org/
Posted: April 2008
