More Americans Successfully Managing Diabetes

By Serena Gordon

HealthDay Reporter

FRIDAY, Feb. 15 (HealthDay News) -- A couple of decades ago, only 2 percent of people with any type of diabetes met or exceeded the three measures of good diabetes management. By 2010, that number had risen to 19 percent, according to new government research.

These measures of good diabetes management are average blood sugar, blood pressure and cholesterol levels. When researchers looked at each measure independently, more than half of people in the study met individual measures.

"Overall, there was a huge improvement between 1988 and 2010. These findings are very encouraging. However, only 19 percent of people were meeting all three goals," said senior study author Catherine Cowie, director of the Diabetes Epidemiology Program at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

One expert had mixed reactions to the study results.

"I see these findings as the glass is half full and half empty. With so much more awareness of diabetes and with newer medications, it's very disappointing to see only 19 percent with good management," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

"If you look at the LDL [bad] cholesterol, only half were on [cholesterol-lowering drugs called] statins, but 100 percent of people with diabetes should be on statins. Only half were well-treated for their blood pressure. That means half of the people with diabetes aren't being treated for blood pressure. I see this as a big problem," Zonszein said.

The study was published online Feb. 15 in Diabetes Care.

The three measures of diabetes management are sometimes called the ABC's of diabetes. "A" is hemoglobin A1C, an estimate of blood sugar levels over the past three months. A1C is expressed as a percentage, and specific A1C goals should be determined by an individual's doctor, but the American Diabetes Association generally recommends that people with diabetes aim for an A1C of less than 7 percent.

The "B" is blood pressure, and the association advises that people with diabetes should have blood pressure of 130/80 millimeters of mercury (mmHg) or less. And "C" is cholesterol, specifically LDL cholesterol. For people with diabetes, the association advises LDL levels be below 100 milligrams per deciliter (mg/dL).

It's important to keep these measures as close to the recommended goals as possible to avoid serious complications, such as heart disease, kidney failure and vision problems.

The researchers reviewed data from four U.S. National Health and Nutrition Examination Surveys, which were done from 1988 to 1994, from 1999 to 2002, 2003 to 2006, and 2007 to 2010. Nearly 5,000 study volunteers said they had diabetes but didn't specify what type they had. All were older than 20.

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