Diabetes Control Has Gotten Much Better

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More than ever, Americans with diabetes are meeting three goals vital for control of their disease, a new study finds. And that could lower their risk for diabetes-related complications such as heart disease, stroke, kidney disease, blindness and amputations.

According to the study results, the number of Americans with diabetes who now meet or exceed goals for the three "ABCs" ― which stand for A1C, blood pressure and cholesterol ―  increased from about 2 percent in 1988 to nearly 19 percent in 2010. A1C is a measure of blood glucose, or sugar, over two to three months.

Experts recommend that people with diabetes aim for an A1C of less than 7 percent; a blood pressure reading under 130/80 mmHg; and an LDL cholesterol reading of less than 100 mg/dL. (LDL is considered the "bad" cholesterol.)

Researchers from the National Institutes of Health and the Centers for Disease Control and Prevention analyzed data gathered by the National Health and Nutrition Examination Surveys from 1988 to 1994 and from 1999 to 2010. NHANES is a federal program of studies that regularly assesses the health and nutritional status of Americans.

The investigators found that 53 percent of Americans met A1C goals from 2007 to 2010, compared with 43 percent from 1988 to 1994. Fifty one percent of people with diabetes met blood pressure goals, up from 33 percent. And 56 percent met cholesterol goals, up from 10 percent.

The researchers attributed the improvement in LDL cholesterol to a dramatic increase in statin use. Some 51.4 percent of adults with diabetes take the cholesterol-lowering drugs, compared with 4.2 percent from 1988 to 1994, according to the study.

Several factors may be driving the improvement in diabetes control,  according to the researchers. Among them: new and improved medications; rising concerns about the obesity and diabetes epidemics in the U.S.; and more attention being placed on healthy behaviors.

Despite the heartening news, not everyone who has diabetes is doing a good job of controlling it. Nearly half of Americans with diabetes did not meet each ABC goal, the researchers wrote.

People 75 or older were more likely to have controlled their A1C than were adults ages 20 to 49. And non-Hispanic whites and non-Hispanic blacks were more likely than Mexican Americans to have an A1C of less than 7 percent.

Blood pressure goals were more likely to be reached by younger people than by older people; by non-Hispanic whites than by non-Hispanic blacks; and by people who had graduated from college than by people who had graduated only from high school.

Finally, older people were more successful at lowering LDL cholesterol than younger people. So were non-Hispanic whites, people who had at least a high school diploma, and men.

"Our data also show that there is much room for improvement," the researchers wrote. "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."

Pass it on: More Americans are controlling their diabetes, but there's room for improvement.

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