Characteristics associated with poor glycemic control among adults with self-reported diagnosed diabetes--National Health and Nutrition Examination Survey, United States, 2007-2010.
Nationally representative estimates indicate that 18.8 million adults in the United States have received a diagnosis with diabetes mellitus. When glycemic control is not optimized, diabetes imposes additional burdensome care requirements, health-care costs, and high risk of disabling complications, and this has been especially evident in socioeconomically disadvantaged and minority populations. For example, higher levels of glycated hemoglobin (A1c) have been associated with increased risk of diabetic retinopathy, increased risk of chronic kidney disease, and increased risk of cardiovascular disease. Reducing A1c levels through combined clinical and effective self-management has demonstrated reduced risk for microvascular complications. Although the most appropriate target A1c levels to achieve optimal health impact might vary among persons, the majority of adults with diabetes will benefit from reduction of A1c levels to ≤7%; targets for patients with a history of severe hypoglycemia, or with limited life expectancy, or with advanced complications, or with certain comorbid conditions might be higher. Nevertheless, an A1c level of 9% constitutes a clearly modifiable, high level of risk that few, if any, persons with diabetes should be exposed to. Accordingly, the Healthy People 2020 objectives include a 10% reduction in the proportion of the diabetes population that has poor glycemic control (A1c >9%) as a target.
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, 4770 Buford Hwy NE, Atlanta, GA 30341, USA. ise1@cdc.gov
Mohammed K
MK
Ali
Kai
K
McKeever Bullard
Giuseppina
G
Imperatore
Lawrence
L
Barker
Edward W
EW
Gregg
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data; D001786:Blood Glucose; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000208:ethnology; D007003:Hypoglycemia / Q000453:epidemiology / Q000208:ethnology; D019458:Insurance Coverage; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D057566:Self Report; D012923:Social Class; D014481:United States / Q000453:epidemiology; D055815:Young Adult; D001741:Black or African American
D001786:Blood Glucose; D006442:Glycated Hemoglobin