American College of Cardiology

A new survey commissioned by the American Diabetes Association (ADA) and the American College of Cardiology (ACC) reveals a serious disconnect among people with diabetes about their risk of cardiovascular disease. The results of the survey—the first activity under the new partnership between the ADA and ACC dubbed Make the Link!—were alarming in that nearly 70 percent of the more than 2,000 patients surveyed did not even consider cardiovascular disease to be a serious risk associated with their diabetes.

The results are particularly disturbing considering that mortality from heart disease is declining in all patient groups except those with diabetes and that nearly two-thirds of people with diabetes die of a heart attack or stroke. In fact, the number of people with diabetes in the United States has increased by nearly 50 percent in the past decade, with the economic toll pegged at $100 billion and rising.

Given that backdrop, the survey results "reinforce the need to help people with diabetes understand their increased risk for heart disease and stroke—and what they can do to reduce those risks," said Health and Human Services Secretary Tommy Thompson at a February 19 press conference to announce the survey results. ACC President-Elect Bruce Fye, MD, and ADA President Christopher Saudek, MD, joined Thompson to discuss the survey results.

The diabetes patients surveyed also voiced little concern about their risk of high cholesterol or hypertension, despite the fact that both are common in diabetes patients and can be controlled with diet, exercise, and drug therapy.

"Many patients with diabetes are living with a very palpable risk for cardiovascular disease," Dr. Fye said. "And by focusing on that risk—as well as the risk of high cholesterol, hypertension, inactivity, and smoking—we can have a dramatic impact on the health of the nation and on the health of individuals."

During the press conference, Dr. Saudek stressed the importance of people with diabetes knowing their ABCs: the results of their A1C test, which measures average insulin levels over the three previous months; their blood pressure; and their cholesterol levels. The ABCs are the cornerstone of an HHS National Diabetes Education Program (NDEP) patient education initiative called "Be Smart About Your Heart."

The focus of the Make the Link! and ABCs campaigns is clearly on prevention, Dr. Fye noted, something which has been a relatively tough sell in the past.

"Prevention is not considered to be exciting. It's not perceived as newsworthy compared to some of the breakthroughs that we hear about every day," he stressed. "Unfortunately, many of those breakthroughs, if you follow them through history, don't necessarily translate into major changes in the frequency or incidence or severity of disease."

Thompson also stressed the importance of prevention and challenged employers and health insurers to help their employees/enrollees with their prevention efforts. Health insurance companies should be "putting in a lot of prevention dollars," Thompson argued, and need to be "front and center" in efforts to prevent heart disease and diabetes.

The ADA and ACC have partnered on the Make the Link! program in an effort to educate physicians and health care providers about the link between diabetes and cardiovascular disease. Through this initiative, the groups will promote prevention of cardiovascular disease and its risk factors through better understanding of the ABCs of diabetes disease management.