Document Detail


Achievement of goals in U.S. diabetes care, 1999-2010.
MedLine Citation:
PMID:  23614587     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tracking national progress in diabetes care may aid in the evaluation of past efforts and identify residual gaps in care.
METHODS: We analyzed data for adults with self-reported diabetes from the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System to examine risk-factor control, preventive practices, and risk scores for coronary heart disease over the 1999-2010 period.
RESULTS: From 1999 through 2010, the weighted proportion of survey participants who met recommended goals for diabetes care increased, by 7.9 percentage points (95% confidence interval [CI], 0.8 to 15.0) for glycemic control (glycated hemoglobin level <7.0%), 9.4 percentage points (95% CI, 3.0 to 15.8) for individualized glycemic targets, 11.7 percentage points (95% CI, 5.7 to 17.7) for blood pressure (target, <130/80 mm Hg), and 20.8 percentage points (95% CI, 11.6 to 30.0) for lipid levels (target level of low-density lipoprotein [LDL] cholesterol, <100 mg per deciliter [2.6 mmol per liter]). Tobacco use did not change significantly, but the 10-year probability of coronary heart disease decreased by 2.8 to 3.7 percentage points. However, 33.4 to 48.7% of persons with diabetes still did not meet the targets for glycemic control, blood pressure, or LDL cholesterol level. Only 14.3% met the targets for all three of these measures and for tobacco use. Adherence to the recommendations for annual eye and dental examinations was unchanged, but annual lipid-level measurement and foot examination increased by 5.5 percentage points (95% CI, 1.6 to 9.4) and 6.8 percentage points (95% CI, 4.8 to 8.8), respectively. Annual vaccination for influenza and receipt of pneumococcal vaccination for participants 65 years of age or older rose by 4.5 percentage points (95% CI, 0.8 to 8.2) and 6.9 percentage points (95% CI, 3.4 to 10.4), respectively, and daily glucose monitoring increased by 12.7 percentage points (95% CI, 10.3 to 15.1).
CONCLUSIONS: Although there were improvements in risk-factor control and adherence to preventive practices from 1999 to 2010, tobacco use remained high, and almost half of U.S. adults with diabetes did not meet the recommended goals for diabetes care.
Authors:
Mohammed K Ali; Kai McKeever Bullard; Jinan B Saaddine; Catherine C Cowie; Giuseppina Imperatore; Edward W Gregg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The New England journal of medicine     Volume:  368     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-25     Completed Date:  2013-05-02     Revised Date:  2013-08-08    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1613-24     Citation Subset:  AIM; IM    
Affiliation:
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. ise1@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Distribution
Aged
Body Mass Index
Diabetes Mellitus / blood,  epidemiology,  therapy*
Female
Health Promotion*
Hemoglobin A, Glycosylated / analysis
Humans
Male
Middle Aged
Nutrition Surveys
Outcome Assessment (Health Care)
Patient Compliance / statistics & numerical data*
Quality Indicators, Health Care
Risk Factors
Sex Distribution
Socioeconomic Factors
United States / epidemiology
Young Adult
Chemical
Reg. No./Substance:
0/Hemoglobin A, Glycosylated
Comments/Corrections
Comment In:
N Engl J Med. 2013 Apr 25;368(17):1650-1   [PMID:  23614592 ]
N Engl J Med. 2013 Jul 18;369(3):287-8   [PMID:  23863067 ]
N Engl J Med. 2013 Jul 18;369(3):287   [PMID:  23863068 ]
Erratum In:
N Engl J Med. 2013 Aug 8;369(6):587

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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