Is Glycemic Control Improving in U.S. Adults?
Article Figures & Tables
Figures
- Figure 1—
A1C distribution by NHANES wave.
Tables
- Table 1—
Characteristics among individuals who have been told they have diabetes and who received an A1C measurement by NHANES wave
NHANES 1999–2000 NHANES 2001–2002 NHANES 2003–2004 n 403 448 482 Age (years) 59.0 ± 0.8 57.4 ± 1.2 59.7 ± 0.8 18–44 (%) 15.6 ± 2.7 22.1 ± 3.4 13.2 ± 1.6 45–64 (%) 45.8 ± 3.3 44.2 ± 3.4 44.9 ± 2.9 65+ (%) 38.6 ± 2.1 33.8 ± 3.4 41.9 ± 3.3 Sex (%) Female 48.4 ± 3.7 49.7 ± 2.0 52.4 ± 1.4 Male 51.6 ± 3.7 50.3 ± 2.0 47.6 ± 1.4 Race/ethnicity (%) White non-Hispanic 61.2 ± 6.2 63.4 ± 3.9 70.8 ± 5.4 Black non-Hispanic 15.8 ± 3.8 14.4 ± 3.0 14.0 ± 2.9 Hispanic 17.0 ± 6.5 15.1 ± 4.5 11.3 ± 3.6 Other 5.9 ± 3.3 7.0 ± 2.4 3.8 ± 1.2 Education (%) <High school 43.2 ± 3.9 30.5 ± 2.7 29.8 ± 2.3 High school 25.7 ± 4.5 24.7 ± 2.2 24.3 ± 2.2 >High school 31.1 ± 4.7 44.8 ± 3.2 45.9 ± 2.7 BMI (kg/m2) 32.3 ± 0.6 31.5 ± 0.5 32.2 ± 0.7 <30 (%) 45.8 ± 4.4 48.7 ± 4.1 42.8 ± 4.0 ≥30 (%) 54.2 ± 4.4 51.3 ± 4.1 57.2 ± 4.0 Income (%) <$20,000 36.3 ± 4.1 28.8 ± 3.4 28.7 ± 2.8 $20,000+ 63.7 ± 4.1 71.2 ± 3.4 71.3 ± 2.8 Insurance (%) 87.0 ± 2.9 91.3 ± 1.8 89.7 ± 1.5 Duration (%) <5 years 34.3 ± 3.6 37.5 ± 3.1 33.7 ± 2.8 5–14 years 33.1 ± 3.0 35.0 ± 3.0 39.1 ± 2.5 15+ years 32.6 ± 3.0 27.3 ± 2.4 27.0 ± 2.8 Smoker (%) Current 16.4 ± 2.6 22.6 ± 2.0 20.4 ± 2.4 Former 33.2 ± 3.7 31.4 ± 2.1 34.6 ± 2.4 Never 50.5 ± 4.9 46.0 ± 2.4 45.0 ± 2.9 Diabetes treatment (%) Diabetes pills only 53.2 ± 3.6 56.6 ± 2.4 58.9 ± 3.6 Insulin only 16.2 ± 2.2 16.4 ± 3.5 13.6 ± 2.0 Pills and insulin 10.7 ± 3.5 9.5 ± 1.8 9.2 ± 1.9 Diet only 19.9 ± 3.7 17.5 ± 2.7 18.3 ± 2.8 -
Data are means ± SEM.
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- Table 2—
Mean A1C and the proportion of individuals with A1C <7.0% by NHANES wave
A1C A1C <7% NHANES 1999–2000 NHANES 2001–2002 NHANES 2003–2004 NHANES 1999–2000 NHANES 2001–2002 NHANES 2003–2004 n 403 448 482 403 448 482 Overall 7.82 ± 0.17 7.47 ± 0.16 7.18 ± 0.11* 36.9% ± 4.4 49.4 ± 3.6* 56.8 ± 3.5* Age 18–44 years 8.71 ± 0.82 7.68 ± 0.31 7.22 ± 0.24 29.7 ± 13.0 42.9 ± 9.1 48.5 ± 5.3 45–64 years 7.81 ± 0.19 7.68 ± 0.25 7.59 ± 0.18 40.0 ± 6.6 47.5 ± 4.2 48.5 ± 5.8 65+ years 7.49 ± 0.16 7.04 ± 0.12* 6.72 ± 0.07* 36.2 ± 6.0 56.3 ± 4.4* 68.3 ± 2.7* Sex Female 7.91 ± 0.28 7.36 ± 0.16 7.04 ± 0.10* 37.1 ± 5.9 52.3 ± 4.0* 58.2 ± 4.6* Male 7.75 ± 0.14 7.57 ± 0.21 7.33 ± 0.23 36.7 ± 4.7 46.6 ± 4.4 55.2 ± 4.5* Race/ethnicity White non-Hispanic 7.52 ± 0.25 7.23 ± 0.14 6.90 ± 0.11* 41.5 ± 6.7 53.3 ± 4.2 63.3 ± 4.3* Black non-Hispanic 8.26 ± 0.21 7.82 ± 0.22 7.61 ± 0.21* 28.5 ± 4.0 44.2 ± 4.2* 44.4 ± 5.0* Hispanic 8.10 ± 0.17 7.71 ± 0.36 8.36 ± 0.34 35.2 ± 5.9 47.1 ± 5.1 37.2 ± 6.2 Other 9.01 ± 0.25 8.40 ± 0.65 7.15 ± 0.18* 16.9 ± 7.8 30.3 ± 15.0 40.6 ± 12.8 Education <High school 7.96 ± 0.13 7.57 ± 0.27 7.57 ± 0.29 30.5 ± 3.9 51.5 ± 5.2* 43.7 ± 5.5 High school 7.32 ± 0.27 7.47 ± 0.16 7.01 ± 0.14 51.6 ± 7.0 47.2 ± 5.2 58.8 ± 5.4 >High school 8.05 ± 0.41 7.40 ± 0.22 7.01 ± 0.12* 33.9 ± 7.4 49.2 ± 4.3 64.2 ± 4.7* BMI BMI <30 kg/m2 8.13 ± 0.31 7.48 ± 0.28 7.34 ± 0.15* 32.8 ± 7.7 53.9 ± 5.0* 50.6 ± 5.1 BMI ≥30 kg/m2 7.62 ± 0.11 7.46 ± 0.13 7.06 ± 0.15* 38.8 ± 4.9 45.8 ± 4.7 61.3 ± 4.5* Income <$20,000 8.18 ± 0.31 7.22 ± 0.20* 7.23 ± 0.19* 33.7 ± 4.9 54.8 ± 4.3* 55.4 ± 5.9* ≥$20,000 7.66 ± 0.17 7.55 ± 0.19 7.16 ± 0.12* 38.4 ± 6.4 47.6 ± 4.1 57.3 ± 3.8* Insurance Uninsured 8.55 ± 0.70 8.44 ± 0.51 7.54 ± 0.38 44.3 ± 9.6 37.8 ± 6.8 46.1 ± 12.2 Insured 7.70 ± 0.15 7.35 ± 0.15 7.13 ± 0.12* 35.6 ± 5.0 50.8 ± 3.7* 58.1 ± 3.8* Duration <5 years 7.94 ± 0.49 7.09 ± 0.17 6.74 ± 0.20* 40.7 ± 7.1 57.8 ± 5.0* 74.2 ± 5.3* 5–14 years 7.94 ± 0.13 7.88 ± 0.32 7.49 ± 0.15* 34.2 ± 4.2 41.3 ± 5.9 50.0 ± 4.5* 15+ years 7.58 ± 0.19 7.46 ± 0.22 7.26 ± 0.15 35.7 ± 7.0 48.2 ± 5.5 44.6 ± 6.5 Smoker Current 7.99 ± 0.33 7.49 ± 0.31 7.48 ± 0.32 28.9 ± 10.5 50.0 ± 8.0 50.2 ± 6.1 Former 7.47 ± 0.14 7.18 ± 0.26 7.00 ± 0.13* 46.6 ± 4.0 55.7 ± 8.0 60.3 ± 5.4* Never 8.00 ± 0.28 7.65 ± 0.20 7.17 ± 0.14* 33.2 ± 5.0 44.6 ± 4.9 57.3 ± 4.8* Diabetes treatment Diabetes pills only 7.80 ± 0.18 7.37 ± 0.17 7.26 ± 0.07* 34.1 ± 4.9 50.3 ± 4.1* 55.3 ± 3.8&* Insulin only 8.70 ± 0.40 8.15 ± 0.31 7.79 ± 0.25 24.2 ± 10.4 30.4 ± 6.7 33.2 ± 9.6 Pills and insulin 8.32 ± 0.20 8.22 ± 0.45 7.92 ± 0.16 13.7 ± 6.9 26.1 ± 12.2 36.3 ± 7.0* Diet only 7.04 ± 0.31 6.73 ± 0.43 6.07 ± 0.18* 62.6 ± 9.8 77.2 ± 7.1 89.7 ± 4.8* -
Data are means ± SEM.
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↵* Significantly different from NHANES 1999–2000 at P < 0.05.
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- Table 3—
Multivariate regression results: effects of demographic factors and NHANES wave on A1C
No treatment variables included Treatment variables included Coefficient (SE) 95% CI Coefficient (SE) 95% CI Age −0.024 (0.008)* −0.039 to −0.008 −0.022 (0.007)* −0.036 to −0.008 Black non-Hispanic 0.553 (0.188)* 0.175 to 0.931 0.495 (0.171)* 0.152 to 0.839 Hispanic 0.424 (0.267) −0.114 to 0.963 0.500 (0.264) −0.032 to 1.032 Other 0.660 (0.284)* 0.087 to 1.232 0.575 (0.263)* 0.044 to 1.105 Female −0.168 (0.150) −0.471 to 0.135 −0.156 (0.137) −0.431 to 0.119 <High school 0.263 (0.213) −0.165 to 0.692 0.208 (0.194) −0.182 to 0.599 High school 0.041 (0.188) −0.338 to 0.421 0.049 (0.169) −0.292 to 0.39 BMI −0.020 (0.013) −0.046 to 0.005 −0.026 (0.011)* −0.049 to −0.003 Insured −0.519 (0.343) −1.21 to 0.171 −0.624 (0.329) −1.286 to 0.038 Income <$20K 0.075 (0.158) −0.244 to 0.394 0.079 (0.147) −0.217 to 0.375 Duration 5–14 years 0.626 (0.205)* 0.213 to 1.04 0.428 (0.205)* 0.015 to 0.84 Duration 15+ years 0.472 (0.216)* 0.036 to 0.908 0.099 (0.229) −0.363 to 0.561 Diabetes pills only — 0.949 (0.182)* 0.582 to 1.317 Insulin only — 1.658 (0.237)* 1.18 to 2.137 Diabetes pills and insulin — 1.564 (0.263)* 1.033 to 2.095 NHANES 2001–2002 −0.308 (0.234) −0.78 to 0.164 −0.317 (0.194) −0.708 to 0.073 NHANES 2003–2004 −0.511 (0.222)* −0.959 to −0.063 −0.500 (0.164)* −0.830 to −0.169 Constant 9.662 (1.042)* 7.563 to 11.761 9.123 (0.902)* 7.305 to 10.941 n 1,132 1,129 R2 0.118 0.196 -
↵* Significant at P < 0.05.
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- Table 4—
Multivariate logistic results: ORs and predictive margins by NHANES wave
No treatment variables included Treatment variables included ORs Predictive margin (%) ORs Predictive margin (%) A1C <7.0% 1999–2000 1.00 37.0 (4.6) 1.00 36.8 (3.6) 2001–2002 1.75 (0.45)* 49.7 (3.2) 1.91 (0.43)* 50.0 (3.1) 2003–2004 2.27 (0.58)* 55.7 (3.4) 2.52 (0.57)* 55.8 (3.4) A1C <8.0% 1999–2000 1.00 61.9 (3.8) 1.00 62.2 (3.2) 2001–2002 1.60 (0.40) 71.4 (2.9) 1.61 (0.37)* 71.3 (2.9) 2003–2004 2.00 (0.46)* 75.4 (2.3) 2.04 (0.40)* 75.3 (2.1) A1C <9.0% 1999–2000 1.00 81.3 (3.4) 1.00 81.4 (3.0) 2001–2002 1.11 (0.37) 82.6 (2.7) 1.09 (0.35) 82.5 (2.8) 2003–2004 1.61 (0.48) 86.9 (1.5) 1.64 (0.44) 87.0 (1.5) -
Data are ORs (SE) or predictive margin (SE). Results control for age, sex, race/ethnicity, education, BMI, insurance, income, and duration of diabetes. Treatment variables include use of diabetes pills only, insulin only, and insulin and diabetes pills; the treatment variable omitted is diet only.
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↵* ORs are significantly different from 1999–2000 at P < 0.05.
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In this Issue
January 2008, 31(1)
