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SAN DIEGO -- From the mid-1990s to 2002, hospitalizations for diabetes-related conditions dropped by 35% and the incidence of end-stage kidney disease fell 30%, researchers with the Centers for Disease Control and Prevention report.
"There has not been much good news over the past two decades regarding quality of care" for diabetics, says Alan Cherrington of Vanderbilt University, president of the American Diabetes Association, whose annual meeting ends here today. "At long last, there might be some good news, a light at the end of the tunnel."
Michael Engelgau, associate director for prevention policy at the CDC's diabetes center, reported Saturday that although the number of hospitalizations for diabetes grew from 439,000 to 473,000 from 1994 to 2002, the rate of hospital admissions fell from 10 per 1,000 people with diabetes to 4 per 1,000.
He said researchers examined data on about 80% of all hospitalizations nationally and counted those for uncontrolled high blood sugar levels; long-term complications such as kidney failure; and foot or lower-leg amputations not related to trauma. During the time studied, the number of people in the USA diagnosed with diabetes increased nearly 64% to 13.6 million, according to the CDC.
The study didn't indicate why hospitalization rates are falling, Engelgau said, but improved therapies and earlier diagnosis and treatment are likely factors. "The bottom line is this does seem to be a very positive trend," he said.
The CDC's Nilka Rios Burrows said better treatment of high blood pressure and high blood sugar levels, both risk factors for kidney disease, could help explain a lower rate of kidney failure from 1996 to 2002.
The 30% decline during those years followed a steady increase that peaked in 1996 at 327 cases per 100,000 people with diabetes. By 2002, the rate dropped to 229 per 100,000, she said. During that period, the number of people who sought treatment (including dialysis or kidney transplantation) and listed diabetes as the primary cause rose from 16,634 in 1990 to 42,665 in 2002.
But scientists say not all the news is so bright. Foot ulcers that result from nerve damage and the loss of sensation in the feet remain a serious problem, says Karel Bakker, chairman of an International Diabetes Federation working group.
Such ulcers, if not treated early, can lead to amputation of the foot or lower leg. "People with diabetes are 25 times more likely to lose a leg than people without the condition," he says.
"Throughout the world, up to 70% of all foot amputations happen to people with diabetes." He says up to 85% of foot ulcers can be prevented with regular examination of feet and footwear, along with prompt treatment.
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