Noting that there is a gap between current and desired patient outcomes in the treatment of diabetes, the National Diabetes Education Program (NDEP) has launched an expanded initiative to promote optimal control of lipids and blood pressure in addition to blood glucose.

Approximately two-thirds of people with diabetes die from cardiovascular disease. Data from a recent national survey showed that over the past 30 years there has been a 27% drop in deaths from heart disease for women without diabetes but a 23% increase in women with diabetes. Similarly, in men without diabetes, there was a 36% decline, compared with a 13% decline in men with diabetes.

Numerous studies have shown that reducing lipid levels reduces the risk of coronary heart disease in people with diabetes, and that lowering blood pressure reduces the risk for stroke, diabetes-related deaths, heart failure and other complications.

The new initiative is designed to help both patients and healthcare providers to:

• Practice goal-oriented management of blood glucose, lipids, and blood pressure to help prevent or delay complications of diabetes
• Ensure that people with diabetes receive diabetes self-management education, including self-monitoring of blood glucose
• Ensure proper food intake and physical activity to help achieve target values, including weight
• Use the HbA1c test to monitor glucose control and to guide therapy to achieve blood glucose target levels
• Use combination drug therapy as necessary to achieve and maintain target values.

NDEP is working with ADA and other diabetes organizations to implement the new initiative that is hoped to play a major role in improving outcomes.