Is glycemic control improving in US adults?
Is glycemic control improving in US adults?
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DOI：
10.2337/dc07-1572
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发表时间：
2008-01-01
期刊：
影响因子：
16.2
通讯作者：
Saaddine, Jinan B.
中科院分区：
文献类型：
--
作者：
Hoerger, Thomas J.;Gregg, Edward W.;Saaddine, Jinan B.
目的 - 本研究的目的是检查近年来诊断为糖尿病的个体的血糖控制是否有所改善。 研究设计和方法 - 我们使用连续三轮国家健康和营养检查调查 (NHANES)：1999-2000 年、2001-2002 年和 2003-2004 年，检查了诊断为糖尿病的成人的 A1C 水平趋势。我们估计了平均 A1C 水平以及 A1C < 7.0、< 8.0 和 < 9.0% 的比例。在控制其他因素后，我们使用多元回归来测试 NHANES 波的 A1C 水平是否存在差异。使用多变量二分逻辑回归和预测边际来测试选定 A1C 区间内的糖尿病患者百分比是否因 NHANES 波而异。 结果：诊断为糖尿病的患者的平均 A1C 水平分别从 1999-2000 年的 7.82% 下降到 2001-2002 年和 2003-2004 年的 7.47 和 7.18%。在控制人口统计和糖尿病病程后，2001-2002年和2003-2004年的A1C水平分别比1999-2000年低0.308（P=0.20）和0.511（P=0.03）个百分点。逻辑结果表明随着时间的推移，A1C < 7.0% 的预测裕度从 1999-2000 年的 37.0% 增加到 2001-2002 年的 49.7% 和 2003-2004 年的 55.7%。结论 - 1999 年至 2004 年期间血糖控制得到改善。这一趋势可能代表糖尿病护理的重要改进，并且是鼓励未来减少糖尿病相关并发症。
OBJECTIVE- The purpose of this study was to examine whether glycemic control has improved in recent years among individuals with diagnosed diabetes.RESEARCH DESIGN AND METHODS - We examined trends in A1C levels for adults with diagnosed diabetes using three consecutive waves of the National Health and Nutrition Examination Survey (NHANES): 1999-2000, 2001-2002, and 2003-2004. We estimated mean AI C levels and the proportion with A1C < 7.0, < 8.0, and < 9.0%. We used multivariate regression to test whether A1C levels differed by NHANES wave after controlling for other factors. Multivariate dichotomous logistic regression and predictive margins were used to test whether the percentages of individuals with diabetes in selected A1C intervals differed by NHANES wave.RESULTS- Mean A1C levels among individuals with diagnosed diabetes declined from 7.82% in 1999-2000 to 7.47 and 7.18% in 2001-2002 and 2003-2004, respectively. After controlling for demographics and diabetes duration, A1C levels were 0.308 (P = 0.20) and 0.511 (P = 0.03) percentage points lower in 2001-2002 and 2003-2004, respectively, than in 1999-2000. The logistic results indicated corresponding improvements over time: the predictive margin for having A1C < 7.0% increased from 37.0% in 1999-2000 to 49.7% in 2001-2002 and to 55.7% in 2003-2004.CONCLUSIONS- Glycemic control improved between 1999 and 2004. This trend may represent an important improvement in diabetes care and is encouraging for future reduction of diabetes-related complications.