12 Aug Fewer Than 25% of Diabetics Achieve ADA Diabetes Care Goals
MedicalResearch.com Interview with:
Pooyan Kazemian, Ph.D.
Instructor in Medicine
Massachusetts General Hospital
MedicalResearch.com: What is the background for this study?
Response: Advances in diabetes care can meaningfully improve outcomes only if they effectively reach the populations at risk. However, it is not known if recent innovations in diabetes treatment and care models have reached the United States population at risk.
MedicalResearch.com: What are the objectives of this study?
Response: Treatment of diabetes is generally focused on meeting four targets: controlling blood sugar, blood pressure, and cholesterol level, as well as promoting smoking cessation.
In this study, we used 2005-2016 nationally representative survey and examination data from Centers for Disease Control and Prevention (CDC). We conducted statistical analyses to evaluate
- (1) what proportion of U.S. adults with diagnosed diabetes achieve diabetes treatment targets,
- (2) whether this has improved over the past 15 years, and
- (3) whether there are age, gender, and racial disparities in the achievement of diabetes treatment targets in the U.S.
MedicalResearch.com: What are the main findings?
Response: We found that among U.S. adults with diagnosed diabetes, only 23% achieve a controlled level of blood sugar, blood pressure, and cholesterol, and do not smoke tobacco. In other words, fewer than one in four American adults with diagnosed diabetes achieve the diabetes care targets recommended by the American Diabetes Association.
Moreover, our results suggest that achievement of none of the diabetes care targets improved over time since 2005. We further found that certain populations demonstrated persistent disparities in meeting diabetes care targets over the study period. In particular, younger age adults (18-44), females, and non-white adults with diabetes had lower odds of achieving diabetes care targets.
MedicalResearch.com: What should readers take away from your report?
Response: Despite major advances in diabetes drug discovery and movement to develop innovative care delivery models over the past two decades, achievement of diabetes care targets has not improved in the United States since 2005.
MedicalResearch.com: What recommendations do you have to improve diabetes outcomes in the U.S. as a result of this study?
Response: Insurance coverage was the strongest indicator of diagnosis, linkage to diabetes care, and achievement of diabetes treatment targets. Therefore, by making health care more affordable, accessible, and efficient, we can take an important step toward improving diabetes outcomes in the United States.
Our findings indicate an immediate need for better approaches to diabetes care delivery, including a continued focus on reaching underserved populations with persistent disparities in care. Moreover, we should continue monitoring the achievement of diabetes care targets on a national level because it can shed light on the population-level steps required to improve diabetes care in the United States.
No disclosures for me and my co-authors.
Kazemian P, Shebl FM, McCann N, Walensky RP, Wexler DJ. Evaluation of the Cascade of Diabetes Care in the United States, 2005-2016. JAMA Intern Med. Published online August 12, 2019. doi:10.1001/jamainternmed.2019.2396
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