National Diabetes Heart Connection Day - November 9

Today is National Diabetes Heart Connection Day, a day to recognize the connection between diabetes and cardiovascular disease.

Diabetes affects 29 million - one in 11 - people in the US and at least double their risk of heart failure, heart attack, stroke, or other cardiovascular complications. Less than half of them, however, are aware that they are at a much higher risk for cardiovascular disease complications.

Connecting Diabetes and Cardiovascular Disease

Diabetes, particularly type 2 diabetes, and cardiovascular diseases are present in the United States at epidemic proportions. It affects 29.1 million people in the US, including 8.1 million people who are undiagnosed.

Cardiovascular disease remains the leading cause of death in the US in general but exacts an even heavier toll among people with diabetes. In fact, nearly seven in ten people with diabetes age 65 and older will die from a heart attack, and one in five will die of stroke. People with type 2 diabetes have twice the risk of having a cardiovascular-related hospitalization compared to people without type 2 diabetes. The co-occurrence of diabetes and cardiovascular disease contributes to the reduced life expectancy of 5-15 years, depending on the age at diabetes diagnosis.

Recognizing the common occurrence of diabetes and cardiovascular disease, the American Heart Association lists diabetes as one of seven major controllable risk factors for cardiovascular disease, along with smoking, physical activity, and obesity among others.

The interrelationship between having diabetes and developing cardiovascular disease is not well known, even among people living with diabetes, which greatly prevents them from lowering their risks. Greater awareness and better education of patients, providers, policymakers, and others of this coexistence is an important step toward saving lives and reducing the burden of diabetes with cardiovascular disease. Validation of such efforts can be drawn from new evidence-based guidelines for patients with diabetes and cardiovascular disease, including the American Diabetes Association’s Standards of Medical Care in Diabetes in 2017 and the European Society of Cardiology Guidelines in 2016.

Cardiovascular Complications Add Significantly to Costs

The CDC estimates that diabetes costs the United States $245 billion a year in medical costs and economical losses from premature death and disability. The medical costs for people with diabetes are twice as high as the medical costs for someone without diabetes. Overall, nearly one out of five health care dollars we spend is associated with caring for someone with diabetes. Of the annual medical costs incurred by a person with diabetes, almost a third is related to diabetes and its related complications with cardiovascular-related complications contributing 28 percent of those costs.

In making people more aware of the prevalent coexistence of diabetes and cardiovascular disease, a measurable impact could be made on these costs. Potential prevention of diagnosis, reductions in hospitalizations, and other healthcare costs are all valuable opportunities to better address these chronic conditions.

Vulnerable Populations are  Disproportionately Affected

Diabetes and co-occurring chronic conditions are particularly prevalent in Medicare. In fact, one in every three dollars Medicare spends goes to treating someone with diabetes.

Among Medicare beneficiaries with at least two chronic conditions, almost a third have diabetes and hypertension, almost one in six have diabetes and ischemic heart disease, and one in ten have diabetes and heart failure. Among those beneficiaries with three or more chronic conditions, close to a third have diabetes, hyperlipidemia, and hypertension; and nearly one in ten have diabetes, ischemic heart disease, and heart failure. 

Further, some racial and ethnic populations are disproportionately affected by type 2 diabetes. In the seminal report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” the Institute of Medicine noted that African Americans, American Indians, and Hispanics experience a 50-100 percent higher burden of illness and death from diabetes than white Americans. 

Facts

There is significant room for improvement in the management of chronic conditions, but what we must not lose sight of is that greater awareness can motivate change - saved lives, increased prevention, earlier detection, better management, and quality of life.

There is a great deal of work still to be done. The data below highlights just a few reasons why. 

• People with Type 2 Diabetes have more than two times the risk for developing heart disease
• Two out of three deaths in people with Type 2 Diabetes are attributed to cardiovascular disease
• Approximately 30 million Americans have diabetes, 8 million are not yet diagnosed, and 86 million with signs of prediabetes
• Of people with diabetes, less than half are aware of their increased risk of cardiovascular diseases. This lack of awareness prevents people with diabetes, their families, and their healthcare providers from addressing risks and improving health

Diabetes in the US

• Diabetes affects 29 million - one in eleven - people in the US. At least, 1 in 3 people will develop diabetes in their lifetime.
• The annual estimated medical costs and economic losses from premature death and disability caused by diabetes are $245 billion.
• More than 25% of the cost of treating diabetes relates to cardiovascular complications
• African Americans, Hispanics, and American Indians have 50 to 100% higher burden of illness and death from diabetes than white Americans.
  
  

Change Starts with Awareness

Making a difference starts with raising awareness of diabetes’ role as a controllable risk factor for cardiovascular disease and related complications. Knowledge of the risk factors, vulnerable populations, and access to care will enable individuals at risk to make needed changes and to seek care not just when sick, but also to take preventive measures to protect their health. Promoting greater awareness among medical providers will support earlier identification and education among at-risk populations and encourage vigilance in treating patients with diabetes to avoid cardiovascular complications.

Policymakers also have an important role in raising awareness and promoting better health outcomes for people living with diabetes. Supporting nationwide awareness efforts, including establishing an annual National Diabetes Heart Connection Day on November 9th, will help bring much-needed attention to the problem. Also, assuring that public health efforts dedicated to either diabetes or cardiovascular disease include educational information that makes the connection between diabetes and cardiovascular disease will extend the reach of these messages. Finally, in the movement toward quality-based payment incentives, assuring that metrics capture the improvement of health outcomes for people with co-morbid conditions, including diabetes with cardiovascular disease, would help to align financial incentives, the health status of the populations being served, and the goals of achieving better overall health and improved quality of care.

Sources:

https://diabetesheartconnection.org/

https://diabetesheartconnection.org/the-facts-1