Changes in diabetes-related complications in the United States, 1990-2010
Open accessAbstract
BACKGROUND: Preventive care for adults with diabetes has improved substantially in recent decades. We examined trends in the incidence of diabetes-related complications in the United States from 1990 through 2010. METHODS: We used data from the National Health Interview Survey, the National Hospital Discharge Survey, the U.S. Renal Data System, and the U.S. National Vital Statistics System to compare the incidences of lower-extremity amputation, end-stage renal disease, acute myocardial infarction, stroke, and death from hyperglycemic crisis between 1990 and 2010, with age standardized to the U.S. population in the year 2000. RESULTS: Rates of all five complications declined between 1990 and 2010, with the largest relative declines in acute myocardial infarction (-67.8%; 95% confidence interval [CI], -76.2 to -59.3) and death from hyperglycemic crisis (-64.4%; 95% CI, -68.0 to -60.9), followed by stroke and amputations, which each declined by approximately half (-52.7% and -51.4%, respectively); the smallest decline was in end-stage renal disease (-28.3%; 95% CI, -34.6 to -21.6). The greatest absolute decline was in the number of cases of acute myocardial infarction (95.6 fewer cases per 10,000 persons; 95% CI, 76.6 to 114.6), and the smallest absolute decline was in the number of deaths from hyperglycemic crisis (-2.7; 95% CI, -2.4 to -3.0). Rate reductions were larger among adults with diabetes than among adults without diabetes, leading to a reduction in the relative risk of complications associated with diabetes. When expressed as rates for the overall population, in which a change in prevalence also affects complication rates, there was a decline in rates of acute myocardial infarction and death from hyperglycemic crisis (2.7 and 0.1 fewer cases per 10,000, respectively) but not in rates of amputation, stroke, or end-stage renal disease. CONCLUSIONS: Rates of diabetes-related complications have declined substantially in the past two decades, but a large burden of disease persists because of the continued increase in the prevalence of diabetes. (Funded by the Centers for Disease Control and Prevention.).
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Hypertriglyceridaemia accounts for about 10% of all pancreatitis cases, and pancreatitis can occur at triglyceride levels of 5-10 mmol/L.
“Notably, HTG is the cause of ∼10% of all cases with pancreatitis, and patients can develop pancreatitis even when their TG concentration is 5-10 mmoL/L (440-880 mg/dL).”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [382]
Diabetes is an independent risk factor for CVD and is associated with higher CVD risk, with a greater excess in women.
“Diabetes itself is an independent risk factor for CVD and is associated with a higher risk of CVD, even more so in women.”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [340]
Although the difference in CVD risk between people with and without diabetes has narrowed substantially over recent decades, strong associations remain between diabetes and vascular outcomes.
“Although the difference in CVD risk between individuals with and without diabetes has narrowed substantially over the last decades, there are strong associations between diabetes and vascular outcomes. 340,341”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [340]
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“Despite exciting advances, the prevalence of diabetic kidney disease remains stable, and large numbers of diabetic patients continue to progress to end-stage renal disease (ESRD).(7,8) Dyslipidemia and abnormalities in renal lipid metabolism may predispose diabetic individuals to lipid accumulation in glomeruli and tu…”
BackgroundThirty-Year Trends in Complications in U.S. Adults With Newly Diagnosed Type 2 Diabetes
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- Authors
- Gregg, E. W., Li, Y., Wang, J., Rios Burrows, N., Ali, M. K., Rolka, D., Williams, D. E., & Geiss, L.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2014-04-17
- Volume
- 370
- Issue
- 16
- Pages
- 1514-1523
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2147222003
- Cited by
- 1,749
- References
- 39
- Citations by year
- 2026: 55 · 2025: 89 · 2024: 91 · 2023: 132 · 2022: 160 · 2021: 134 · 2020: 173 · 2019: 160 · 2018: 182 · 2017: 171 · 2016: 172 · 2015: 162 · 2014: 65 · 2013: 1
- FWCI
- 152.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Keywords
- diabetes complications, incidence trends, lower limb amputation, end-stage renal disease, acute myocardial infarction, stroke, hyperglycemic crisis, diabetes prevalence, preventive medicine, diabetes mortality, age-standardized rates, relative risk reduction, disease burden, hospitalization rates, diabetes self-management
- MeSH terms
- Adult, Amputation, Surgical, Health Surveys, Humans, Hyperglycemia, Kidney Failure, Chronic, Myocardial Infarction, United States, Incidence, Stroke, Diabetes Complications
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