The burden of chronic hyperglycemia.
Diabetic complications constitute the principal clinical and economic burdens of diabetes. Available evidence indicates that sustained reduction in hyperglycemia (as measured by HbA1c) reduces the incidence of diabetic complications, including microvascular and neurological disease, and will likely reduce the risk of macrovascular disease. In the U.S., targeting interventions to aged and ethnic subpopulations, which are currently receiving suboptimal care, and increasing efforts to lower the average HbA1c concentrations one or two percentage points in people with diabetes would be a more cost-effective goal than aiming for a theoretical HbA1c threshold below which the risk of complications is negligible. Other risk factors for diabetic complications, such as obesity, hypertension, cigarette smoking, and hypercholesterolemia, must also be addressed to reduce the burden of diabetes.
Clark
C M
CM
Regenstrief Institute for Health Care, Regenstrief Health Center, Indiana University Medical Center, Indianapolis 46202-2859, USA. clark_c@regenstrief.iupai.edu
D017281:Cost of Illness; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood / Q000191:economics / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000191:economics / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000503:physiopathology; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D006949:Hyperlipidemias / Q000209:etiology; D006973:Hypertension / Q000209:etiology; D007333:Insulin Resistance; D009765:Obesity; D012307:Risk Factors
D006442:Glycated Hemoglobin