Copied from: http://www.docguide.com/news/content.nsf/news/B517C57E897616C285256E2100712B50 without permission as an archive copy in case the link vanishes from the web
Journal of the American Medical Association (JAMA)
01/20/2004
By Joene Hendry
There is a significant improvement in the control of total cholesterol levels,
but not in the control of blood glucose levels and blood pressure, among adults
with previously diagnosed diabetes who participated in the Third National Health
and Nutrition Examination Survey (NHANES III) compared with those who
participated in NHANES 1999-2000.
"Progress in improving risk factors for vascular disease among individuals with
diagnosed diabetes in the United States over nearly a decade has been modest,"
writes Catherine C. Cowie, PhD, National Institute of Diabetes and Digestive and
Kidney Diseases, Bethesda, Maryland, and colleagues.
The researchers analysed data from 1,265 adult participants in NHANES III,
conducted in 1988 through 1994, with those of 441 adult participants in NHANES
1999-2000, to assess trends in the control of vascular disease risk factors in
diabetics according to target levels of glycosylated haemoglobin, blood
pressure, and total serum cholesterol established by the American Diabetes
Association.
The 2 studies revealed similar age-standardised prevalence of previously
diagnosed diabetes - 5.4% in NHANES III and 6.1% in NHANES 1999-2000 - and,
while participants with diabetes were similar in age and sex, there was a trend
toward younger age at diagnosis - 50.7 years in NHANES III compared with 46.7
years in NHANES 1999-2000. However, mean body mass index (BMI) increased
significantly from 29.9 to 32.3 and the percentage of those with diagnosed
diabetes and BMI greater than or at 30 increased from 41.6% to 54.6% from NHANES
III to NHANES 1999-2000.
The 2 studies showed similar levels of mean glycosylated haemoglobin - 7.6 and
7.8, respectively. However, only 37.0% of the adults in the more recent study
had glycosylated haemoglobin levels at the American Diabetes Association goal of
less than 7%.
In the earlier study, 29.0% of the participants had the recommended blood
pressure of less than 130 mm Hg systolic and 80 mm Hg diastolic. This percentage
rose to 35.8% of the later study population.
Overall levels of total serum cholesterol decreased from a mean of 222.8 mg/dL
to 208.9 mg/dL from the earlier to the later study. However, the later study
revealed that 50.0% of men and 53.8% of women still had total serum cholesterol
levels at 200 mg/dL or higher.
In the earlier NHANES III, 5.2% of the adults with diabetes achieved currently
recommended goals of glycosylated haemoglobin level, blood pressure, and total
serum cholesterol. By NHANES 1999-2000 this percentage rose to only 7.3%, which
indicates only a small percentage of US adults diagnosed with diabetes are
achieving currently recommended levels of control.
JAMA 2004;291:335-342.