Achievement of Goals in U.S. Diabetes Care, 1999–2010

Mohammed K. Ali, M.B., Ch.B., M.B.A., Kai McKeever Bullard, M.P.H., Ph.D., Jinan B. Saaddine, M.D., M.P.H., Catherine C. Cowie, M.P.H., Ph.D., Giuseppina Imperatore, M.D., Ph.D., and Edward W. Gregg, Ph.D.

N Engl J Med 2013; 368:1613-1624April 25, 2013DOI: 10.1056/NEJMsa1213829

Abstract
Article
References
Citing Articles (1): Background
Tracking national progress in diabetes care may aid in the evaluation of past efforts and identify residual gaps in care.

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Methods
We analyzed data for adults with self-reported diabetes from the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System to examine risk-factor control, preventive practices, and risk scores for coronary heart disease over the 1999–2010 period.

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Results
From 1999 through 2010, the weighted proportion of survey participants who met recommended goals for diabetes care increased, by 7.9 percentage points (95% confidence interval [CI], 0.8 to 15.0) for glycemic control (glycated hemoglobin level <7 .0="" 0.8="" 1.6="" 10-year="" 10.3="" 10.4="" 11.6="" 11.7="" 12.7="" 14.3="" 15.1="" 15.8="" 17.7="" 2.8="" 20.8="" 3.0="" 3.4="" 3.7="" 30.0="" 33.4="" 4.5="" 4.8="" 48.7="" 5.5="" 5.7="" 6.8="" 6.9="" 65="" 8.2="" 8.8="" 9.4="" adherence="" age="" all="" and="" annual="" blood="" but="" by="" change="" cholesterol="" ci="" control="" coronary="" daily="" deciliter="" decreased="" dental="" diabetes="" did="" disease="" examination="" examinations="" eye="" foot="" for="" glucose="" glycemic="" heart="" hg="" however="" increased="" individualized="" influenza="" ldl="" level.="" level="" levels="" lipid-level="" lipid="" lipoprotein="" liter="" low-density="" measurement="" measures="" meet="" met="" mg="" mm="" mmol="" monitoring="" not="" of="" older="" only="" or="" p="" participants="" per="" percentage="" persons="" pneumococcal="" points.="" points="" pressure="" probability="" receipt="" recommendations="" respectively.="" respectively="" rose="" significantly="" still="" target="" targets="" the="" these="" three="" to="" tobacco="" unchanged="" use.="" use="" vaccination="" was="" with="" years="">

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Conclusions
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.

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