Diabetes Self-Management Blog

More people with diabetes are meeting the recommended targets for three key areas of diabetes control than in previous decades, according to recent research from the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). Approximately 26 million people in the United States have diabetes.

People whose A1C (a measure of blood glucose control over the previous 2–3 months), blood pressure, and LDL (“bad”) cholesterol levels fall outside the suggested levels are more likely to develop diabetes complications, such as heart disease, stroke, and kidney disease. Goals for these measures must be individualized based on factors such as a person’s age, type of diabetes, and complications from diabetes. However, for many people with the condition, an A1C goal below 7% is recommended, along with a blood pressure goal of less than 130/80 and an LDL cholesterol level of less than 100 mg/dl.

To determine how many people are meeting the recommended targets, researchers looked at data from the National Health and Nutrition Examination Surveys (NHANES) from 1988–1994 and 1999–2010. (NHANES is a program of studies that combines interviews and physical examinations to determine the health and nutritional status of people in the United States.) The investigators found that 53% of Americans with diabetes met A1C goals, 51% met blood pressure goals, and 56% met cholesterol goals in the 1999–2010 survey, compared to 43%, 33%, and 10% respectively in the earlier survey. The number of participants able to meet or exceed all three of the measures demonstrating good diabetes management rose from about 2% in 1988–1994 to about 19% in in 2007–2010.

The researchers suspect that improvements in cholesterol levels were largely due to the increase in use of the cholesterol-lowering drugs known as statins: In 1988–1994, only 4% of people with diabetes were taking these medicines, but that number rose to 51% from 2007—2010.

“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,” noted Judith Fradkin, MD, director of the NIDDK Division of Diabetes, Endocrinology, and Metabolic Diseases.

In spite of the improvements, the researchers note that the results show a need for better diabetes control. In particular, young adults and Mexican Americans were below average in meeting A1C and cholesterol goals and non-Hispanic blacks were less likely to meet blood pressure and cholesterol goals.

According to first author Sarah Stark Casagrande, PhD, “While diabetes control has improved in these populations, some disparities remain, demonstrating the need for improved management of the disease to prevent its devastating complications.”

For more information, read the article “Big Improvement in Diabetes Control Over Past Decades,” or see the study in the journal Diabetes Care. And to learn more about controlling A1C, blood pressure, and cholesterol, see the following articles:

H-B-A-1-C (What It Is and Why It Matters)
The Pressure Is On: Hypertension and Diabetes
Lifestyle Habits for Lipid Management

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