A study conducted and funded by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) shows that more people are meeting recommended goals in the three key markers of diabetes control. That is, A1C — which assesses blood sugar or glucose over the past three months — blood pressure and cholesterol.
When these measures fall outside healthy ranges, people are more likely to be at a higher risk for complications of diabetes, including heart disease, stroke, kidney disease, blindness, and amputation.
Despite the improvement, the results show continued need for better diabetes control. In particular, young people and some minority groups were below average in meeting the goals.
The report, which was published in the 15 February online version of Diabetes Care, shows that, from 1988 to 2010, the number of people with diabetes able to meet or exceed all three of the measures that demonstrate good diabetes management rose from about 2 percent to about 19 percent. Each measure also showed substantial improvement, with over half of people meeting each individual goal in 2010.
Researchers analyzed data from the National Health and Nutrition Examination Surveys from 1988-1994 and 1999-2010. They compared the various years to analyze the improvement.
“The most impressive finding was the significant improvement in diabetes management over time across all groups,” said Catherine Cowie, Ph.D., the study’s senior author and director of the Diabetes Epidemiology Program at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which conducted and funded the study.
“However, we see a lot of room for improvement, for everyone, but particularly for younger people and some minority groups.”
According to 2007-2010 data on Americans with diabetes:
• 53 percent met A1C goals, compared to 43 percent in 1988-1994 data
• 51 percent met blood pressure goals, compared to 33 percent in 1988-1994 data
• 56 percent met cholesterol goals, compared to 10 percent in 1988-1994 data
The increase in the use of statins may explain the improved cholesterol control. The study shows the cholesterol control increased from roughly four percent of people with diabetes during 1988-1994 to 51 percent during 2007-2010. Glucose control seems to be worse in Mexican-Americans and in younger adults. In fact, only 44 percent of Mexican-Americans met A1C goals, versus 53 percent of whites and blacks in 2007-2010 data. People between 20-49 years old were less likely to meet A1C goals than older people.
“It is particularly disturbing that good control was seen less frequently in young people,” said Judith Fradkin, M.D., director of the NIDDK Division of Diabetes, Endocrinology, and Metabolic Diseases. “Research has shown that good diabetes control early in the course of disease has long-lasting benefits reducing the risk of complications.”
Goals for A1C, blood pressure, and cholesterol must be individualized for people with diabetes. No two people are exactly the same. A person’s age, type of diabetes, diabetes medications, complications from diabetes, as well as other factors all necessitate a personalize goal.
For A1C, a goal for many people is below 7 percent. It is particularly important for people with long life expectancies to control A1C to protect against eye, nerve, and kidney disease in the future. Goals can be less stringent for people with limited life expectancy, since complications develop over time.
The normal blood pressure goal for most people is 130/80. Moderate- or high-dose statin therapy is recommended for people over 40 with diabetes, with a goal of keeping the low-density lipoprotein (LDL) less than 100 milligrams per deciliter.
The CDC estimates that the prevalence of diagnosed diabetes has more than doubled between 1988 and 2012, from nearly four percent of the US population to nearly nine percent. The American Diabetes Association (ADA) states that there are over 25 million people in the US alone with diabetes.
To help people improve their health, the National Diabetes Education Program (NDEP), an initiative of the NIH and the CDC, is working to assist people in making positive, lasting changes to improve their health. NDEP’s Make A Plan tool can help make these changes become part of a daily routine to support people in reaching their health goals. The NIDDK's National Diabetes Information Clearinghouse creates and promotes
This article was taken from a press release by the NIH. It is not intended to replace the medical advice of your physician. If you are experiencing any of the symptoms of diabetes, make an appointment with your physician.
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