Improvements in risk factor control among persons with diabetes in the United States: Evidence and implications for remaining life expectancy

Abstract 

Aims

To examine whether A1c, blood pressure, and cholesterol values changed for U.S. adults with diagnosed diabetes between 1988–1994 and 2005–2006. We then project the impact of these changes on life expectancy and diabetes-related complications.

Methods

We estimated changes in hemoglobin A1c, blood pressure, and total cholesterol between 1988–1994 and 2005–2006 using regression analysis and data from the National Health and Nutrition Examination Survey. We projected the potential effects on life expectancy and complications using the CDC-RTI Diabetes Cost-Effectiveness Model.

Results

A1c fell by 0.68 percentage points (P=0.001) among U.S. adults with diagnosed diabetes. Among those with diabetes and hypertension, systolic and diastolic blood pressure fell by 5.66 and 8.15mmHg, respectively (P=0.005 and P=0.001). Among those with diabetes and high cholesterol, total cholesterol fell by 36.41mg/dL (P=0.001). These improvements were projected to increase life expectancy for persons with newly diagnosed diabetes by 1.0 year.

Conclusions

Risk factor control has improved in the United States. Persons newly diagnosed with type 2 diabetes in 2005 have a better prognosis than persons diagnosed with diabetes 11 years earlier.

Keywords: Chronic disease, Diabetes, Risk factors, Modeling