1. NATIONAL D I ABET ES DEI TACUON PROGRA M Changing the way diabetes is treated.

2. Purpose of the Session Update on NDEP activities Review accomplishments of race/ethnic work groups Plans for new comprehensive care campaign Obtain input for future planning Changing the way diabetes is treated

3. How is science driving NDEP activities? DCCT: Metabolic control matters. Changing the way diabetes is treated

4. How has the science evolved? UKPDS: Blood pressure control matters 4S and West of Scotland: cholesterol control makes a difference Meta-analysis of aspirin data: aspirin therapy works for PWD Changing the way diabetes is treated

5. How have practice guidelines changed? JNC VI ATP III ADA Clinical Guidelines Changing the way diabetes is treated

6. We are changing the way diabetes is treated. DQIP AMA, JCAHO and NCQA AHA New therapies Major education campaigns Changing the way diabetes is treated

7. NDEP Accomplishments Control Your Diabetes. For Life. campaign Educational materials Clinical tools Key partners working together Changing the way diabetes is treated

8. We still need to bridge the gap. Current CareDesired Care

9. 5 Components of the NDEP Awareness Campaigns Special Populations Partnership Network Community Interventions Health Systems

10. Changing the Way Diabetes Is Treated

11. Comprehensive Diabetes Control Changing the way diabetes is treated

12. Risk Factors for Complications of Type 2 Diabetes PercentPercent NHANES III, 1991-1994 Hba1c Albumin- Hyper LDL HDL Trigly- BMI Cigarette >7% uria tension>130 30 smoking >200

13. The Good News: People with diabetes can take steps to significantly reduce their risk of heart disease Changing the way diabetes is treated

14. The ABCs of Diabetes Control A = A1C B = Blood pressure C = Cholesterol

15. Changing the way diabetes is treated The Science Behind the ABCs of Diabetes Control

16. Changing the way diabetes is treated A1C DCCT : Intensive blood glucose therapy reduced risk of microvascular complications EDIC : Microvascular benefits endure EDIC : Intensive therapy reduced risk of atherosclerosis

17. Changing the way diabetes is treated Blood Pressure UKPDS 10-point reduction in systolic and 5-point reduction in diastolic blood pressure 21% decrease in heart attack risk 44% decrease in stroke risk

18. Changing the way diabetes is treated Blood Pressure Hypertension Optimal Treatment Study (HOT) Three diastolic goals: 80, 85, and 90 51% reduction in CV events at diastolic pressure of 80

19. Changing the way diabetes is treated Controlling Blood Pressure in People with Diabetes ABCD and HOPE: effectiveness of ACE inhibitors HOPE: 25 - 30% reduction in risk of heart attack, stroke, or CV death UKPDS: beta blockers and ACE inhibitors worked equally well

20. Changing the way diabetes is treated Controlling Cholesterol in People with Diabetes CARE: 25% reduction in heart attacks or CV deaths using statin therapy 4S significantly reduced CHD incidence with simvastatin NCEP: recommends LDL- cholesterol < 100 for people with diabetes

21. The Bottom Line: Aggressive control of blood glucose, blood pressure, and cholesterol can make a big difference in outcomes for people with diabetes. Changing the way diabetes is treated

22. Be Smart About Your Heart Campaign Logo Insert “Be Smart” campaign logo

23. Diabetes is a key risk factor for CVD Rigorous control of blood glucose, blood pressure, and cholesterol helps prevent CVD and other diabetes complications. Move more, eat better, and take medications as prescribed, to feel better and enjoy a better quality of life. Campaign Messages Changing the way diabetes is treated

24. Campaign Messages What are my A1C, blood pressure and cholesterol numbers? What are my treatment goals? What do I need to do to reach my goals? Changing the way diabetes is treated

25. Campaign Components Educational materials Mass media messages Special populations tailored messages Clinical tools Participation of NDEP partner organizations

26. How can you help? Promote the ABCs of Diabetes to your patients and your colleagues Reinforce the physical activity and healthy eating messages Changing the way diabetes is treated

27. Find out more: Call 1-800-438-5383 to order materials Call 1-877-232-3422 for Hispanic campaign materials Call 1-800-860-8747 to speak with a diabetes information specialist Visit the NDEP Web Sites –http://ndep.nih.govhttp://ndep.nih.gov –www.cdc.gov./diabeteswww.cdc.gov./diabetes Changing the way diabetes is treated