Diabetes: why Americans have such a hard time controlling blood sugar

According to the study, the percentage of American adults with diabetes who achieved glycemic control worsened between 2007 and 2010, and again between 2015 and 2018.

Photo: Photo by Artem Podrez from Pexels / Pexels

Diabetes is an issue that will never go unnoticed. Especially in recent years that we have had the opportunity to have more information and thus worry more about our health. The truth is that it is one of the most alarming chronic diseases today: it contributes to 10-15% of deaths in the United States. In addition, there are updated data from the World Health Organization (WHO), in which it is confirmed that in 2019 diabetes was the direct cause of 1.5 million deaths, and the total number of cases is also increasing. estimates that nearly 1.6 million Americans are diagnosed with diabetes each year. As if that weren’t enough, recent research led by the Johns Hopkins Bloomberg School of Public Health found disappointing data: the percentage of American adults with diabetes who achieved glycemic control it worsened between 2007 and 2010, and again between 2015 and 2018.

As expected, these findings come to emphasize even more (especially after a pandemic year), the continuing challenges that arise in the control of diabetes. According to the study authors, it is time to take more control of the situation, it is no joke to say that diabetes is one of the most prevalent health conditions and in many cases it is directly related to controllable factors. The team used data from an annual government-sponsored health study to assess trends in blood sugar control among adults with diabetes, as well as the control of blood pressure and cholesterol.

It is well known that type 2 diabetes is the most common form of the disease and is strongly related to diet and lifestyle factors. According to the study, it is estimated that affects more than 13% of the adult population in the United States and it increases the risks of other serious diseases, especially cardiovascular ones. Based on this, traditional approaches to diabetes care are aspects focused on reducing chronic high blood sugar / glucose, maintaining blood pressure below levels considered “hypertension” and good cholesterol control. . In addition to aspects related to lifestyle; Unfortunately, the study shows that most people do not have this disease under control.

According to information released in the study: the proportion of adults with glycemic control improved between 1999 and 2007, but then it fell from 57.4% to 50.5% between 2007 and 2018. In addition, the study authors also observed a decrease in the proportion of people who achieved blood pressure control. It is worth mentioning that the proportion that achieved adequate cholesterol control stabilized.

Elizabeth Selvin, lead author of the study and professor in the Department of Epidemiology at the Bloomberg School, stated in the press release that it is rather disturbing findings. “There has been a real decline in glycemic control for a decade and, overall, only a small proportion of people with diabetes are simultaneously meeting the key goals of glycemic control, blood pressure control, and high cholesterol control.”

What data was the study based on?

The researchers had access to data including interviews and clinical examinations of approximately 5000 people nationwide. The sample consisted of 6,653 survey participants from 1999 to 2018 who were at least 20 years old, not pregnant, and reported having been diagnosed with diabetes outside of pregnancy.

Among the most relevant data that occurred between 1999 and 2010: the percentage of respondents who achieved glycemic control, defined as HbA1c levels below 7.0%, increased from 44% to 57.4%. However, it dropped dramatically between 2015 and 2018. Something similar happened with blood pressure: it rose steadily from 64% between 1999 and 2002 to 74.2% between 2011 and 2014, then fell to 70.4% between 2015 and 2018. Finally, the percentage of people with diabetes who controlled lipoprotein cholesterol high-density (non-HDL) increased from 25.3% between 1999 and 2002 to 52.3% between 2007 and 2010, but then reached only 55.7% between 2015 and 2018.

In conclusion, the researchers discovered that the proportion of people who managed to control the 3 risk factors increased from 9% between 1999 and 2002, to 24.9% between 2007-2010. And then it was reduced to 22.2% between 2015 and 2018. Another of the authors who led the study Michael Fang spoke about it, who stated that the trends uncovered in the study are a wake-up call. Well, they point out that millions of Americans with diabetes have a higher risk of serious complications, that is, the study suggests that the worsening of diabetes control may already be having a detrimental effect at the national level.

Another highly relevant aspect suggested by the study’s findings is that something changed since 2010 and that it had an influence by delaying progress in controlling diabetes risk factors. Based on this, the researchers undertook the task of analyzing two large clinical trials, published in 2008. In which they found that the intensive reduction of HbA1c to very low levels did not lead to the cardiovascular benefits that people expected, and some trial participants saw a increased risk of hypoglycemia. It is worth mentioning that to date things have changed, that is, it was in 2008 when the results of these trials were published; today the market offers numerous new and improved diabetes medications. Which if they allow reducing HbA1c (glycated hemoglobin test, a blood test for type 2 diabetes and prediabetes) and without causing hypoglycemia.

Although much research work remains to be done, these types of studies come to give greater clarity to medical personnel and enrich strategies in the management of diabetes. Which should not only be focused solely on one optimal glycemic control of patients with diabetes, it is necessary to integrate the good management of risk factors, make adjustments in lifestyle, diet, stress levels and sleep cycles.

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