Is Glycemic Control Improving in U.S. Adults?

  1. Thomas J. Hoerger, PHD1,
  2. Joel E. Segel, BA1,
  3. Edward W. Gregg, PHD2 and
  4. Jinan B. Saaddine, MD2
  1. 1RTI International, Research Triangle Park, North Carolina
  2. 2Centers for Disease Control and Prevention, Atlanta, Georgia
  1. Address correspondence and reprint requests to Thomas J. Hoerger, Director, RTI-UNC Center of Excellence in Health Promotion Economics, RTI International, 3040 Cornwallis Rd., P.O. Box 12194, Research Triangle Park, NC 27709. E-mail: tjh{at}rti.org

Abstract

OBJECTIVE—The purpose of this study was to examine whether glycemic control has improved in recent years among individuals with diagnosed diabetes.

RESEARCH DESIGN AND METHODS—We examined trends in A1C levels for adults with diagnosed diabetes using three consecutive waves of the National Health and Nutrition Examination Survey (NHANES): 1999–2000, 2001–2002, and 2003–2004. We estimated mean A1C levels and the proportion with A1C <7.0, <8.0, and <9.0%. We used multivariate regression to test whether A1C levels differed by NHANES wave after controlling for other factors. Multivariate dichotomous logistic regression and predictive margins were used to test whether the percentages of individuals with diabetes in selected A1C intervals differed by NHANES wave.

RESULTS—Mean A1C levels among individuals with diagnosed diabetes declined from 7.82% in 1999–2000 to 7.47 and 7.18% in 2001–2002 and 2003–2004, respectively. After controlling for demographics and diabetes duration, A1C levels were 0.308 (P = 0.20) and 0.511 (P = 0.03) percentage points lower in 2001–2002 and 2003–2004, respectively, than in 1999–2000. The logistic results indicated corresponding improvements over time: the predictive margin for having A1C <7.0% increased from 37.0% in 1999–2000 to 49.7% in 2001–2002 and to 55.7% in 2003–2004.

CONCLUSIONS—Glycemic control improved between 1999 and 2004. This trend may represent an important improvement in diabetes care and is encouraging for future reduction of diabetes-related complications.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 12 October 2007. DOI: 10.2337/dc07-1572.

    The findings and conclusion in this article are those of the authors and do not necessarily reflect the views of the Centers for Disease Control and Prevention.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted October 9, 2007.
    • Received August 9, 2007.
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  1. Published online before print October 12, 2007, doi: 10.2337/dc07-1572 Diabetes Care January 2008 vol. 31 no. 1 81-86
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