Risk factor control and preventive practices improved among adults with diabetes in the U.S between 1999 and 2010 but continue to remain suboptimal, according to a study published April 25 in the New England Journal of Medicine.  Although improvements in glycemic control, blood pressure and other measures were observed, less than one-half of patients met targets for glycemic control, blood pressure or LDL cholesterol levels.

The study, which looked at more than 100,000 adults with self-reported diabetes, found that over the course of the decade studied, there were increases in the proportion of patients who met recommended goals for glycemic control (7.9 percent increase), individualized glycemic targets (9.4 percent increase), blood pressure (11.7 percent increase) and LDL cholesterol (20.8 percent increase). Further, the risk of coronary heart disease decreased by 2.8-3.7 percentage points. However, only one-third to one-half of patients met targets for glycemic control, blood pressure or LDL cholesterol, and tobacco use remained unchanged. Only 14.3 percent of patients met targets for all three measures and tobacco use.

"Although there were improvements in risk-factor control and adherence to preventive practices from 1999 to 2010, tobacco use remained high, and almost half of U.S. adults with diabetes did not meet the recommended goals for diabetes care," the investigators said. "Furthermore, continued increases in the incidence of diabetes suggest that the absolute numbers of affected persons and those with poor control of risk factors continue to grow. Continued nationwide evaluation of diabetes control will be important to sustain improvements in care," they conclude.

Keywords: Incidence, Coronary Artery Disease, Cholesterol, LDL, Blood Glucose, Risk Factors, Blood Pressure, Tobacco Use, New England, Diabetes Mellitus