Glycemic Control in US Adult Type 2 Diabetics Is Getting Worse?

Current data is showing that there is a 20% decrease of patients in good glycemic control. The preliminary data from NHANES 1999-2000 reported in Diabetes Care reveal interesting facts about changing diabetes treatment patterns in type 2 diabetes. Despite the call for more aggressive treatment after the UKPDS publication, NHANES 1999-2000 finds there is a 20% decrease of patients in good glycemic control compared to NHANES III (1988-1994).

What can be seen behind the figures? The proportion of patients using oral agents has significantly increased: less patients were on diet only and on insulin only in 1999-2000. Metformin and the insulin sensitizers introduced after 1995 have lead to a shift from the more time consuming, but definitely more effective life-style interventions and/or insulin treatment, to the more convenient for both primary care professionals and patients use of oral antidiabetic agents.

Should professionals prioritize patients’ convenience rather than considering better patient health outcome when prescribing therapy? A dangerous trend to be debated in the professional community.

Glycemic control from 1998-2000 among US adults with type 2 diabetes
Diabetes Care, January 2004; vol.27, 17-20