Study finds dramatic improvement in blood-sugar control among diabetes patients

More room for improvement remains, study authors say

NEW YORK — Control of A1C, blood pressure and cholesterol among patients with diabetes has improved markedly, but more room for improvement remains, according to a new study.

The study, funded by the National Institutes of Health and the Centers for Disease Control and Prevention and published online in the Feb. 15 issue of the journal Diabetes Care, found that from 1988 to 2010, the number of people with diabetes able to meet or exceed measures of A1C, blood pressure and cholesterol — which together indicate good diabetes management — rose from 2% to 19%. More than half of people met each individual goal in 2010.

"The most impressive finding was the significant improvement in diabetes management over time across all groups," said senior study author and director of the Diabetes Epidemiology Program at the National Institute of Diabetes and Digestive and Kidney Diseases Catherine Cowie. "However, we see a lot of room for improvement for everyone, but particularly for younger people and some minority groups."

The study was based on data from the "National Health and Nutrition Examination Surveys" from 1988 to 1994 and 1999 to 2010. According to 2007-2010 data, 53% of Americans with diabetes met A1C goals, compared with 43% in 1988-1994; 51% met blood pressure goals, compared with 33% in 1988-1994; and 56% met cholesterol goals, compared with 10% in 1988-1994. Improvements in cholesterol were attributed to increased use of cholesterol-lowering statin drugs.

Many people's goal A1C level is less than 7%. According to the American Diabetes Association, 26 million Americans have diabetes, while 79 million have pre-diabetes, meaning they are at increased risk of Type 2 diabetes and heart disease.

Nevertheless, blood glucose control was found to be worse among Mexican-Americans and younger adults, with 44% of Mexican Americans attaining their A1C goals, compared with 53% of whites and blacks; people ages 20 to 49 years were also less likely to meet their A1C goals than older people.

"It is particularly disturbing that good control was seen less frequently in young people," NIDDK Division of Diabetes, Endocrinology and Metabolic Diseases director Judith Fradkin said. "Research has shown that good diabetes control early in the course of disease has long-lasting benefits reducing the risk of complications. For people with long life expectancy after diagnosis of diabetes, it's especially important to focus on meeting diabetes management goals as early as possible, because with that longer life comes a greater chance of developing complications if they do not control their diabetes."

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