title: Comparison of demographic factors and cardiovascular risk factor control among U.S. adults with type 2 diabetes by insulin treatment classification.
abstract: OBJECTIVE
  Data on glucose and cardiovascular disease (CVD) risk factor control among persons with type 2 diabetes mellitus (DM) according to insulin treatment status are lacking. We examined DM control, risk factors, and comorbidities among U.S. persons according to insulin treatment status.
  
  
  METHODS
  In the U.S. National Health and Nutrition Examination Surveys 2003-2006, we examined in 10,637 adults aged ≥30 with type 2 DM the extent of control of A1c, LDL-C, HDL-C, triglycerides, and blood pressure (BP) and composite goal attainment by insulin use status.
  
  
  RESULTS
  6.6% (n=889, projected to 14.3 million) had type 2 DM; of these, 22.9% were insulin users and 57.2% were treated only by other diabetes medications. Overall, 58.2% had an A1c<7% (53 mmol/mol) (insulin users 33.1%, non-insulin treated 66.1%, and 77.9% of those not on medication, p<0.0001). Overall, 44.2% were at a BP goal of <130/80 mmHg, 43.8% had an LDL-C<100 mg/dl (2.6 mmol/L), and 13.9% a BMI<25 kg/m(2). Only 10.2% were simultaneously at A1c, LDL, and BP goals (5.4% of those on insulin).
  
  
  CONCLUSIONS
  U.S. adults with type 2 DM, especially those treated with insulin remain inadequately controlled for A1c and CVD risk factors and have a high prevalence of comorbidities.
authors.affiliation: Heart Disease Prevention Program, Division of Cardiology, Department of Medicine, University of California, Irvine, CA 92697, USA.
authors.forename: Kalina
authors.initials: K
authors.lastname: Wong
authors.forename: Diana
authors.initials: D
authors.lastname: Glovaci
authors.forename: Shaista
authors.initials: S
authors.lastname: Malik
authors.forename: Stanley S
authors.initials: SS
authors.lastname: Franklin
authors.forename: Gail
authors.initials: G
authors.lastname: Wygant
authors.forename: Uchenna
authors.initials: U
authors.lastname: Iloeje
authors.forename: Hongjun
authors.initials: H
authors.lastname: Kan
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D015897:Comorbidity; D003710:Demography; D048909:Diabetes Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000145:classification / Q000627:therapeutic use; D007328:Insulin / Q000145:classification* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin