Blood Sugar Control is Declining in Adults With Diabetes

Blood sugar and blood pressure control is declining among adults with diabetes, according to the results of a recent study.

To better understand the diabetes epidemic in the United States, the researchers conducted a nationwide study to examine trends over the past several decades.

The researchers examined glycemic control (defined as HbA1c levels below 7.0%), blood pressure control (defined as <140/90 mmHg), and bad cholesterol (defined as non-HDL cholesterol lower than 130 mg/dl).

Data from the National Health and Nutrition Examination Survey was utilized, including 6653 participants from 1999 to 2018. All participants were aged 20 years or older, were not pregnant, and had been diagnosed with diabetes outside of pregnancy.

The results indicated that the percentage of adults with diabetes who achieved glycemic control rose from 44.0% in 1999 to 2002, to 57.4% in 2007 to 2010. This number then decreased significantly to 50.5% in 2015 to 2018.

The percentage of adults with diabetes who achieved blood pressure control followed a similar trend. In 1999 to 2002, 64.0% of adults achieved blood pressure control, which increased to 74.2% in 2011 to 2014, before falling to 70.4% in 2015 to 2018.

Further, the percentage of individuals with diabetes who controlled their bad cholesterol levels increased significantly from 25.3% in 1992 to 2002 to 52.3% in 2007 to 2010, and further increased to 55.7% in 2015 to 2018.

Individuals who properly managed all 3 risk factors increased from 9.0% in 1999 to 2002, to 24.9% in 2007 to 2010, before decreasing to 22.2% in 2015 to 2018.

The researchers cited the results of two large clinical trials from 2008, the ACCORD and ADVANCE trials, as a possible explanation for some of the changing trends. The trials examined how aggressive lowering of glycemic levels impacted cardiovascular benefits and adversely resulted in an increased risk of hypoglycemia. These results may have encouraged health care providers to be less aggressive in glycemic control, the researchers speculated.

“These trends are a wake-up call, since they mean that millions of Americans with diabetes are at higher risk for major complications,” the study authors concluded. “Our study suggests that worsening control of diabetes may already be having a detrimental effect at the national level.”

—Leigh Precopio

Reference:

Major study of diabetes trends shows Americans’ blood sugar control is getting worse. News release. Newswise; June 7, 2021. Accessed June 9, 2021. https://www.newswise.com/articles/major-study-of-diabetes-trends-shows-americans-blood-sugar-control-is-getting-worse