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In a Whirlwind of Diabetes News, A Glimmer of Hope for Reduced Complications

Published: 4/29/14
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By Kelly Close

Dear reader,

It’s been such a whirlwind month in the world of diabetes that I can hardly catch my breath. Can you? Who would have guessed that the FDA Advisory Committee meeting would prominently feature patient advocates supporting a promising new therapy, a controversial New York Times piece by Dr. Elizabeth Rosenthal on the rising costs of type 1 diabetes would be published (very important topic, weak research), and super encouraging data from the New England Journal of Medicine would show major reductions in long-term complications for people with diabetes – all within days (d-a-y-s!) of each other?

April has been a busy month for diabetes advocates. On April 1, Managing Editor Adam Brown and I spoke before the FDA Advisory Board, urging for more options and better therapies.  You can also find Adam’s slides are here and you can see my talk here and slides here. Less than a week later, the New York Times ran a front-page article on the rising costs of type 1 – though the piece had good intentions, we believe it undervalued innovative therapies/devices and misunderstood the experience of living with this disease.  You can read our open letter to the New York Times here, which implores the writer to deepen her understanding of what living with diabetes is really like.

Not all was gloomy in April. In fact, one development had me dancing a jig at home and in the office! Why? An article published in the prestigious New England Journal of Medicine found that diabetes-related complications dropped dramatically in the US from 1990 to 2010. CDC researchers studied the changes in long-term complications (including lower-body amputations, end-stage kidney failure, heart attack, stroke, and death from hyperglycemic crisis) and found impressive results: heart attacks fell ~70%, deaths from hyperglycemic crisis were down ~65%, and both stroke and lower-body amputations dropped~50% compared to twenty years ago. Wow.

The clear area of continued need is end-stage kidney disease, which declined by ~30% - this is great but not as great as it needs to be, given the costs and the pain. The data show what many patients have suspected for a long time – that treating and preventing diabetic nephropathy is still a profound unmet need. Please read our learning curve for more information on diabetic nephropathy and other diabetes complications and how to prevent this all-too-common and painful complication.

Importantly, this historic paper also showed that the reductions in each category were substantially greater in people with diabetes than in people without diabetes. This strongly suggests that the improvement in complications is due to diabetes-specific factors, which would of course include new drugs and technology over the past two decades. I can’t imagine this progress would have been possible without the huge strides in medical innovation and without the amazing work of so many researchers, scientists, and other leaders in diabetes. This is precisely the type of data that we wish the New York Times would consider when publishing an article on diabetes treatment costs (granted, this news wasn’t out yet) – advances in medicine can be costly in the short-term, but they are often well worth the expense of reduced long-term complications. 

But we still have much work to do – advocating for better therapies and innovative technologies, making the voices of patients heard in the public and at the FDA, and ultimately preventing diabetes-related complications as well as the disease itself. For now, I’m pleased with how far we have come since I was diagnosed 27 years ago. It gives me a glimpse of all that we have been working toward – a future where people with diabetes live happier, healthier, and improved lives.

Very best,

 

Interested in learning more about diabetes complication? Please read our learning curve on diabetic neuropathy and diabetic macular edema, and Kerri’s reflections on dealing with diabetes complications.

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