CardioExchange Archive

There’s a glimmer of good news amidst all the recent bad news about diabetes. Although the prevalence of diabetes has doubled over the last generation, more people today are reaching their treatment goals than in the past. New data from the National Health and Nutrition Examination Surveys (NHANES), published online today in Diabetes Care, show that efforts to control hemoglobin A1C, blood pressure, and LDL cholesterol in patients diagnosed with diabetes have achieved some success, but they also demonstrate that there’s enormous room for improvement.

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

The researchers compared data on the ABCs — A1C, blood pressure, and LDL cholesterol — from 1988-1994 and 2007-2010 and found significant improvements in the rate of control for all three parameters:

• A1C control (<7%) increased from 43.1% to 52.5%.
• Blood pressure control (<130/80 mmHg) increased from 33.2% to 51.1%.
• LDL cholesterol control (<100 mg/dL) increased from 9.9% to 51.4%.

Despite the improved trend, 81.2% of patients failed to achieve all three goals.

The authors attributed the large gains to advances resulting from the important benefits achieved in key pivotal trials in glycemic control and hypertension and lipid management. The particularly large improvement in control of LDL cholesterol was likely caused by the availability and increased use of statins.

The researchers said it was “noteworthy that we found younger people with diabetes were less likely to meet A1C and LDL goals and showed smaller improvements in meeting each ABC goal.” They concluded:

As the U.S. population ages and diabetes prevalence increases, it becomes increasingly urgent to find ways to overcome barriers to good diabetes management and deliver affordable, quality care so those with diabetes can live a longer and healthier life without serious diabetes complications.