Public Release: 

Improvement in glycemic control among patients with diabetes may have plateaued

The JAMA Network Journals

Bottom Line: The improvement in glycemic control observed between 1998 and 2010 among patients with diabetes appears to have plateaued during 2007-2014. More participants reported having a test for HbA1c in the prior year and were aware of their HbA1c result and target.

Why The Research Is Interesting: In 2014, an estimated 30.3 million people (9.4 percent) in the United States had diabetes. Improving glycemic control reduces the risk of diabetes-related vascular complications.

Who and When: 2,908 participants of the National Health and Nutrition Examination Survey (NHANES). NHANES is a program of studies designed to assess the health and nutritional status of adults and children in the United States and is unique because it combines interviews and physical examinations. Survey periods for this study were 2007-2008, 2009-2010, 2011-2012, and 2013-2014.

What (Study Measures): Hemoglobin (Hb) A1c levels, a measure of glycemic control. Glycemic control was defined as good (HbA1c level < 7 percent); moderate (<8 percent); and poor (> 9 percent).

How (Study Design): A population epidemiology study describes characteristics of health and disease in one or more large populations, typically without detailed information about underlying causes.

Authors: Saeid Shahraz, M.D., Ph.D., of Brandeis University, Waltham, Massachusetts and coauthors

Results: Glycemic control did not change overall between 2007-2008 and 2013-2014. There was an increase in the proportion of participants who reported have a test for HbA1c in the prior year and were aware of their HbA1c result and target.

Study Limitations: The study design does not allow conclusions to be drawn about why the findings.

Study Conclusions: There was no change in glycemic control among people in the U.S. with diabetes between 1998-2010 and 2007-2014.

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(doi:10.1001/jama.2017.11927)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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