Outcomes for US adults with diabetes along 3 essential measures of metabolic health remained essentially unchanged between 2005 and 2016, according to a new study.
Investigators from the Massachusetts General Hospital found that fewer than 1 in 4 American adults diagnosed with diabetes met disease control targets for blood sugar, blood pressure, or cholesterol. Rates of smoking cessation, also a goal of diabetes treatment, have stagnated as well.
Lead author Pooyan Kazemian, PhD, in a hospital news release said "Our results suggest that, despite major advances in diabetes drug discovery and movement to develop innovative care delivery models over the past two decades, achievement of diabetes care targets has not improved in the United States since 2005." The study was published online August 12 in JAMA Internal Medicine.
Diabetes affects 30.2 million US adults with prevalence expected to reach 54 million by 2030. It is a leading cause of cardiovascular disease and mortality as well as of significant disability related to micro- and macrovascular complications.
Cascade of care, disparities. Study authors analyzed serial cross-sectional studies included in the 2005-2016 National Health and Nutrition Examination Survey (n = 1742 diagnosed and 746 undiagnosed) to evaluate the cascade of diabetes care in the United States, defined as diabetes diagnosis, linkage to care and achievement of treatment targets.
They were also interested in potential disparities in diabetes care related to age, gender, and race.
Primary outcome measures were proportion of participants overall and stratified by age, sex, and race/ethnicity who were linked to diabetes care and met glycemic (A1c <7.0%-8.5%, depending on age, complications), blood pressure (<140/90 mm Hg), cholesterol level (low-density lipoprotein cholesterol <100 mg/dL), and smoking abstinence targets and a composite of all targets.