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. 2017 Aug;8(4):863-873.
doi: 10.1007/s13300-017-0280-5. Epub 2017 Jun 23.

Achievement of Glycated Hemoglobin Goals in the US Remains Unchanged Through 2014

Ginger Carls  1 , Johnny Huynh  2 , Edward Tuttle  2 , John Yee  3 , Steven V Edelman  3   4   5
Affiliations

Achievement of Glycated Hemoglobin Goals in the US Remains Unchanged Through 2014

Ginger Carls et al. Diabetes Ther. 2017 Aug.

Abstract

Introduction: Previous research has found that the percentage of US adults with diabetes achieving a glycated hemoglobin (HbA1c) target of <7.0% with currently available treatments has been fairly constant from 2003 to 2010, remaining at just over 50% [1]. The objective of this study was to compare the most recent data (2011-2014) with earlier data to track progress on HbA1c target achievement, for both the general target of <7.0% and inferred individualized targets based on age and the presence of complications.

Methods: Data from 2677 adults with self-reported diabetes from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014 were examined to determine the percentage of adults who achieved HbA1c targets of <7% and an individualized target based on age and comorbidities. National estimates are reported by using weights that account for the complex sampling design of the NHANES.

Results: The percentage of people with diabetes and HbA1c <7.0% slightly declined from 52.2% (95% CI 48.7-55.7%) to 50.9% (95% CI 47.2-54.7%) between the two most recent waves of data. Achievement of individualized targets declined from 69.8% (95% CI 66.5-73.0%) to 63.8% (95% CI 60.1-67.5%). The percentage with HbA1c >9.0% increased from 12.6% (95% CI 10.5-14.8%) to 15.5% (95% CI 12.9-18.2%). Achievement of individualized targets varied by age group and presence of comorbidities, but exhibited similar trends as general target achievement.

Conclusions: Despite the development of many new medications to treat diabetes during the past decade, the proportion of patients achieving glycemic control targets has not improved.

Funding: Intarcia Therapeutics.

Keywords: Diabetes; Glycemic control; Trends; United States.

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Figures

Fig. 1
Fig. 1
Percentage of all adults with diabetes: HbA1c targets (individualized and general target HbA1c <7.0%); 95% confidence intervals are shown. Individualized targets are defined in Table 1
Fig. 2
Fig. 2
Achievement of individualized targets by age group and the presence of complications. Based on N = 1326 (2011–2014), 1351 (2007–2010), 943 (2003–2006), and 857 (1999–2002) survey respondents; weighted to represent US adults with diabetes; 95% confidence intervals are shown. Individualized targets are defined in Table 1
Fig. 3
Fig. 3
US adults with HbA1c exceeding 8.0% and 9.0% (poor control). Based on N = 1326 (2011–2014), 1351 (2007–2010), 943 (2003–2006), and 857 (1999–2002) survey respondents; weighted to represent US adults with diabetes; 95% confidence intervals are shown
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