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The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988-2010.
Diabetes Care. 2013 Aug; 36(8):2271-9.DC

Abstract

OBJECTIVE

To determine the prevalence of people with diabetes who meet hemoglobin A1c (A1C), blood pressure (BP), and LDL cholesterol (ABC) recommendations and their current statin use, factors associated with goal achievement, and changes in the proportion achieving goals between 1988 and 2010.

RESEARCH DESIGN AND METHODS

Data were cross-sectional from the National Health and Nutrition Examination Surveys (NHANES) from 1988-1994, 1999-2002, 2003-2006, and 2007-2010. Participants were 4,926 adults aged ≥ 20 years who self-reported a previous diagnosis of diabetes and completed the household interview and physical examination (n = 1,558 for valid LDL levels). Main outcome measures were A1C, BP, and LDL cholesterol, in accordance with the American Diabetes Association recommendations, and current use of statins.

RESULTS

In 2007-2010, 52.5% of people with diabetes achieved A1C <7.0% (<53 mmol/mol), 51.1% achieved BP <130/80 mmHg, 56.2% achieved LDL <100 mg/dL, and 18.8% achieved all three ABCs. These levels of control were significant improvements from 1988 to 1994 (all P < 0.05). Statin use significantly increased between 1988-1994 (4.2%) and 2007-2010 (51.4%, P < 0.01). Compared with non-Hispanic whites, Mexican Americans were less likely to meet A1C and LDL goals (P < 0.03), and non-Hispanic blacks were less likely to meet BP and LDL goals (P < 0.02). Compared with non-Hispanic blacks, Mexican Americans were less likely to meet A1C goals (P < 0.01). Younger individuals were less likely to meet A1C and LDL goals.

CONCLUSIONS

Despite significant improvement during the past decade, achieving the ABC goals remains suboptimal among adults with diabetes, particularly in some minority groups. Substantial opportunity exists to further improve diabetes control and, thus, to reduce diabetes-related morbidity and mortality.

Authors+Show Affiliations

Social & Scientific Systems, Inc, Silver Spring, Maryland, USA. scasagrande@s-3.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23418368

Citation

Stark Casagrande, Sarah, et al. "The Prevalence of Meeting A1C, Blood Pressure, and LDL Goals Among People With Diabetes, 1988-2010." Diabetes Care, vol. 36, no. 8, 2013, pp. 2271-9.
Stark Casagrande S, Fradkin JE, Saydah SH, et al. The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988-2010. Diabetes Care. 2013;36(8):2271-9.
Stark Casagrande, S., Fradkin, J. E., Saydah, S. H., Rust, K. F., & Cowie, C. C. (2013). The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988-2010. Diabetes Care, 36(8), 2271-9. https://doi.org/10.2337/dc12-2258
Stark Casagrande S, et al. The Prevalence of Meeting A1C, Blood Pressure, and LDL Goals Among People With Diabetes, 1988-2010. Diabetes Care. 2013;36(8):2271-9. PubMed PMID: 23418368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988-2010. AU - Stark Casagrande,Sarah, AU - Fradkin,Judith E, AU - Saydah,Sharon H, AU - Rust,Keith F, AU - Cowie,Catherine C, Y1 - 2013/02/15/ PY - 2013/2/19/entrez PY - 2013/2/19/pubmed PY - 2014/3/19/medline SP - 2271 EP - 9 JF - Diabetes care JO - Diabetes Care VL - 36 IS - 8 N2 - OBJECTIVE: To determine the prevalence of people with diabetes who meet hemoglobin A1c (A1C), blood pressure (BP), and LDL cholesterol (ABC) recommendations and their current statin use, factors associated with goal achievement, and changes in the proportion achieving goals between 1988 and 2010. RESEARCH DESIGN AND METHODS: Data were cross-sectional from the National Health and Nutrition Examination Surveys (NHANES) from 1988-1994, 1999-2002, 2003-2006, and 2007-2010. Participants were 4,926 adults aged ≥ 20 years who self-reported a previous diagnosis of diabetes and completed the household interview and physical examination (n = 1,558 for valid LDL levels). Main outcome measures were A1C, BP, and LDL cholesterol, in accordance with the American Diabetes Association recommendations, and current use of statins. RESULTS: In 2007-2010, 52.5% of people with diabetes achieved A1C <7.0% (<53 mmol/mol), 51.1% achieved BP <130/80 mmHg, 56.2% achieved LDL <100 mg/dL, and 18.8% achieved all three ABCs. These levels of control were significant improvements from 1988 to 1994 (all P < 0.05). Statin use significantly increased between 1988-1994 (4.2%) and 2007-2010 (51.4%, P < 0.01). Compared with non-Hispanic whites, Mexican Americans were less likely to meet A1C and LDL goals (P < 0.03), and non-Hispanic blacks were less likely to meet BP and LDL goals (P < 0.02). Compared with non-Hispanic blacks, Mexican Americans were less likely to meet A1C goals (P < 0.01). Younger individuals were less likely to meet A1C and LDL goals. CONCLUSIONS: Despite significant improvement during the past decade, achieving the ABC goals remains suboptimal among adults with diabetes, particularly in some minority groups. Substantial opportunity exists to further improve diabetes control and, thus, to reduce diabetes-related morbidity and mortality. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/23418368/The_prevalence_of_meeting_A1C_blood_pressure_and_LDL_goals_among_people_with_diabetes_1988_2010_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=23418368 DB - PRIME DP - Unbound Medicine ER -