US trends in glycemic control, treatment, and comorbidity burden in patients with diabetes.

This study explored trends over time in diabetes prevalence, glycemic control, and antidiabetic therapy choices among adults (18-64 years) and older adults (≥ 65 years). Factors that predict diabetes outcomes were explored. The study was cross-sectional, with data from the 1999 to 2004 National Health and Nutrition Examination Survey. The study group consisted of 1211 persons with self-reported diabetes. Other information obtained from the study included self-reported medication for diabetes, hypertension, stroke, heart failure, and health status. The survey also provided examination or laboratory tests of obesity, nephropathy, and glycosylated hemoglobin level. Descriptive and logistic regression analyses were used in the study. The study showed that the proportion of diabetics with good glycemic control increased during the period from 1999 to 2004. However, nearly half of the adults and one third of older adults with diabetes did not reach glycemic control in 2003-2004. Overall, 59% of adults and 46% of older adults were obese. There was a high prevalence of hypertension, heart failure, stroke, and nephropathy among patients with diabetes, especially in older adults. The results indicate a high percentage of poor glycemic control among persons with diabetes. There were also a substantial number of comorbid conditions associated with diabetes.