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. 2020 Aug;34(8):107607.
doi: 10.1016/j.jdiacomp.2020.107607. Epub 2020 Apr 27.

Time in suboptimal glycemic control over 10 years for patients newly diagnosed with type 2 diabetes

Jaejin An  1 , Gregory A Nichols  2 , Lei Qian  3 , Teresa N Harrison  3 , Zhuoxin Li  3 , Mercedes A Munis  3 , Rong Wei  3 , Tracey Weiss  4 , Swapnil Rajpathak  4 , Kristi Reynolds  3
Affiliations

Time in suboptimal glycemic control over 10 years for patients newly diagnosed with type 2 diabetes

Jaejin An et al. J Diabetes Complications. 2020 Aug.

Abstract

Objective: To estimate time in suboptimal glycemic control among patients with incident type 2 diabetes (T2D) over 10 years.

Methods: We calculated percent of time in suboptimal glycemic control using three A1C thresholds (8%, 7.5%, 7%) following T2D diagnosis. Stratified analyses were conducted based on age and A1C levels at T2D diagnosis.

Results: We identified 28,315 patients with incident T2D. Percent of time in suboptimal glycemic control increased with T2D duration. Mean percent time in suboptimal A1C control in the first 2 years following diagnosis was 30%, 34% and 40% for the 8%, 7.5%, and 7% thresholds, respectively. In the 6-10 years following T2D diagnosis, the percent time in suboptimal A1C control increased to 39%, 48% and 61%, for the 8%, 7.5%, and 7% thresholds, respectively. Time in suboptimal glycemic control was longer among younger patients aged 20-44 versus ≥65 years and those with higher A1C (>8%) versus lower A1C (<7%) at diagnosis.

Conclusions: Over 10 years following diagnosis, T2D patients spent one-third to over one-half of their time in suboptimal glycemic control. Reducing time spent above desired A1C targets could lower risk of microvascular and macrovascular complications.

Keywords: Glycemic control; Hemoglobin A1c; Type 2 diabetes.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: J.A., K.R. are employees of Kaiser Permanente Southern California and G.A.N. is employee of Kaiser Permanente Northwest who received funding through their institutions from Merck & Co., Inc. for the conduct of this study. T.W., S.R. are employees of Merck & Co., Inc.

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