Improvements in risk factor control among persons with diabetes in the United States: evidence and implications for remaining life expectancy.
OBJECTIVE
To examine whether A1c, blood pressure, and cholesterol values changed for U.S. adults with diagnosed diabetes between 1988-1994 and 2005-2006. We then project the impact of these changes on life expectancy and diabetes-related complications.


METHODS
We estimated changes in hemoglobin A1c, blood pressure, and total cholesterol between 1988-1994 and 2005-2006 using regression analysis and data from the National Health and Nutrition Examination Survey. We projected the potential effects on life expectancy and complications using the CDC-RTI Diabetes Cost-Effectiveness Model.


RESULTS
A1c fell by 0.68 percentage points (P=0.001) among U.S. adults with diagnosed diabetes. Among those with diabetes and hypertension, systolic and diastolic blood pressure fell by 5.66 and 8.15mmHg, respectively (P=0.005 and P=0.001). Among those with diabetes and high cholesterol, total cholesterol fell by 36.41mg/dL (P=0.001). These improvements were projected to increase life expectancy for persons with newly diagnosed diabetes by 1.0 year.


CONCLUSIONS
Risk factor control has improved in the United States. Persons newly diagnosed with type 2 diabetes in 2005 have a better prognosis than persons diagnosed with diabetes 11 years earlier.
Hoerger
Thomas J
TJ
RTI International, Research Triangle Park, NC 27709, USA. tjh@rti.org
Zhang
Ping
P
Segel
Joel E
JE
Gregg
Edward W
EW
Narayan
K M Venkat
KM
Hicks
Katherine A
KA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D048909:Diabetes Complications / Q000453:epidemiology* / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012044:Regression Analysis; D012307:Risk Factors; D012308:Risk Management / Q000379:methods*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D002784:Cholesterol; D006442:Glycated Hemoglobin