Texas Diabetes, Winter 2005 Page: 4
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The US Department of Health and
Human Services has announced the
publication of Diabetes: A National
Plan for Action, a step-by-step
guide to activities and resources.
"This action plan provides specific steps
that everyone can take to fight diabetes;' said
Victor Gonzalez, MD, McAllen, a member of
the Texas Diabetes Council who helped
develop the plan. "The most effective way to
bring this problem under control is for
government, business, healthcare providers,
schools, communities, and the media, as well
as people with diabetes and their families, to
The plan focuses on specific, attainable
action steps. Goals for individuals include
reducing fat consumption, taking the stairs
instead of the elevator, and getting screened
for diabetes. Businesses can provide healthy
food in vending machines and cafeterias and
turn some conference space into exercise
rooms. Civic groups can create community
gardens and install distance markers on
sidewalks to encourage walking for health.
Government agencies can develop
evidence-based strategies to prevent, detect,
and treat diabetes as well as programs to
Editor's Note: Diabetes: A National Plan for
Action is available on the Web at:
Prevalence of lower-extremity disease in
the US adult population >40 years of age
with and without diabetes
1999-2000 National Health and Nutrition Examination Survey
Edward W Gregg PhD; Paul Sorlie, PhD; Ryne Paulose-Ram, PhD; Qiuping Gu, MD; Mark S. Eberhardt,
PhD; Michael Wolz, MA; Vicki Burt, ScM; Lester Curtin, PhD; Michael Engelgau, MD; Linda Geiss, MA
Diabetes Care 27:1591-1597, 2004
Although lower-extremity disease (LED), which includes lower-extremity peripheral arterial
disease (PAD) and peripheral neuropathy (PN), is disabling and costly, no nationally representative
estimates of its prevalence exist. The aim of this study was to examine the prevalence of lower-
extremity PAD, PN, and overall LED in the overall US population and among those with and
without diagnosed diabetes.
Research design and methods
The analysis consisted of data for 2,873 men and women aged >40 years, including 419 with
diagnosed diabetes, from the 1999-2000 National Health and Nutrition Examination Survey. The
main outcome measures consisted of the prevalence of lower-extremity PAD (defined as ankle-
brachial index <0.9), PN (defined as >1 insensate area based on monofilament testing), and of any
LED (defined as either PAD, PN, or history of foot ulcer or lower-extremity amputations).
Of the US population aged >40 years, 4.5 percent (95 percent CI 3.4 -5.6) have lower extremity
PAD, 14.8 percent (12.8 -16.8) have PN, and 18.7 percent (15.9 -21.4) have any LED. Prevalence of
PAD, PN, and overall LED increases steeply with age and is higher (P<0.05) in non-Hispanic blacks
and Mexican Americans
than non-Hispanic whites.
The prevalence of LEDs is
approximately twice as
high for individuals with
diagnosed diabetes (PAD
9.5 percent [5.5-13.4]; PN
28.5 percent [22.0 -35.1];
any LED 30.2 percent
[22.1-38.3]) as the overall
LED is common in the
US and twice as high
among individuals with
diagnosed diabetes. These
ately affect the elderly, non
Hispanic blacks, and
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Texas Diabetes Program. Texas Diabetes, Winter 2005, periodical, 2005; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth576186/m1/4/: accessed June 17, 2019), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.