Abstract
Objective: To examine the distribution of diabetic medications among adults with type 2 diabetes, and the association between glucose control and treatment approach in the US population. Methods: Interview and prescription medication data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were used to determine the treatment approach for US adults with type 2 diabetes. Mean glycosylated hemoglobin (HbA1c) and the proportion of adults meeting recommended guidelines for glucose control were estimated for each treatment approach. The most important study limitation was that participants were not asked what type of diabetes they had. Among adults with diabetes, a classification algorithm was used to identify those with type 2 diabetes. Results: During 1999-2004, approximately 60% of adults with type 2 diabetes used oral agents only to manage their diabetes. The distribution of oral treatment therapies changed over time (p<0.01); the most prevalent treatment shifted from sulfonylurea monotherapy in 1999-2000 (23.0%) to any oral agent regimen containing thiazolidinedione (TZD) in 2003-2004 (21.4%). Overall, only 52.2% of adults with type 2 diabetes met the American Diabetes Association (ADA) goal for HbA1c control (<7.0%) during 1999-2004. Across oral agent treatment categories, the proportion with HbA1c controlled at the 7.0 level was significantly lower (p<0.01) for those on triple therapy (31.9%) (TZD, sulfonylurea, and metformin), than those on metformin alone (62.2%), likely reflecting a progressive treatment approach of prescribing additional medications for those with uncontrolled HbA1c levels. Conclusions: Use of multiple oral agents among adults with type 2 diabetes has increased (sulfonylurea and metformin, p = 0.03, triple therapy, p = 0.02). However, nearly half of adults with type 2 diabetes have HbA1c levels above ADA guidelines for control, indicating that available treatments could be used more optimally, and new diabetic agents may be needed.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1605-1613 |
| Number of pages | 9 |
| Journal | Current Medical Research and Opinion |
| Volume | 25 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 2009 |
| Externally published | Yes |
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Keywords
- Glucose control
- HbA
- NHANES
- Prescription medication
- Treatment
- Type 2 diabetes
ASJC Scopus subject areas
- Medicine(all)
Cite this
Treatment approach and HbA1c control among US adults with type 2 diabetes : NHANES 1999-2004. / Dodd, Allison Hedley; Colby, Margaret S.; Boye, Kristina S.; Fahlman, Cheryl; Kim, Sunny H; Briefel, Ronette R.
In: Current Medical Research and Opinion, Vol. 25, No. 7, 07.2009, p. 1605-1613.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment approach and HbA1c control among US adults with type 2 diabetes
T2 - NHANES 1999-2004
AU - Dodd, Allison Hedley
AU - Colby, Margaret S.
AU - Boye, Kristina S.
AU - Fahlman, Cheryl
AU - Kim, Sunny H
AU - Briefel, Ronette R.
PY - 2009/7
Y1 - 2009/7
N2 - Objective: To examine the distribution of diabetic medications among adults with type 2 diabetes, and the association between glucose control and treatment approach in the US population. Methods: Interview and prescription medication data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were used to determine the treatment approach for US adults with type 2 diabetes. Mean glycosylated hemoglobin (HbA1c) and the proportion of adults meeting recommended guidelines for glucose control were estimated for each treatment approach. The most important study limitation was that participants were not asked what type of diabetes they had. Among adults with diabetes, a classification algorithm was used to identify those with type 2 diabetes. Results: During 1999-2004, approximately 60% of adults with type 2 diabetes used oral agents only to manage their diabetes. The distribution of oral treatment therapies changed over time (p<0.01); the most prevalent treatment shifted from sulfonylurea monotherapy in 1999-2000 (23.0%) to any oral agent regimen containing thiazolidinedione (TZD) in 2003-2004 (21.4%). Overall, only 52.2% of adults with type 2 diabetes met the American Diabetes Association (ADA) goal for HbA1c control (<7.0%) during 1999-2004. Across oral agent treatment categories, the proportion with HbA1c controlled at the 7.0 level was significantly lower (p<0.01) for those on triple therapy (31.9%) (TZD, sulfonylurea, and metformin), than those on metformin alone (62.2%), likely reflecting a progressive treatment approach of prescribing additional medications for those with uncontrolled HbA1c levels. Conclusions: Use of multiple oral agents among adults with type 2 diabetes has increased (sulfonylurea and metformin, p = 0.03, triple therapy, p = 0.02). However, nearly half of adults with type 2 diabetes have HbA1c levels above ADA guidelines for control, indicating that available treatments could be used more optimally, and new diabetic agents may be needed.
AB - Objective: To examine the distribution of diabetic medications among adults with type 2 diabetes, and the association between glucose control and treatment approach in the US population. Methods: Interview and prescription medication data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were used to determine the treatment approach for US adults with type 2 diabetes. Mean glycosylated hemoglobin (HbA1c) and the proportion of adults meeting recommended guidelines for glucose control were estimated for each treatment approach. The most important study limitation was that participants were not asked what type of diabetes they had. Among adults with diabetes, a classification algorithm was used to identify those with type 2 diabetes. Results: During 1999-2004, approximately 60% of adults with type 2 diabetes used oral agents only to manage their diabetes. The distribution of oral treatment therapies changed over time (p<0.01); the most prevalent treatment shifted from sulfonylurea monotherapy in 1999-2000 (23.0%) to any oral agent regimen containing thiazolidinedione (TZD) in 2003-2004 (21.4%). Overall, only 52.2% of adults with type 2 diabetes met the American Diabetes Association (ADA) goal for HbA1c control (<7.0%) during 1999-2004. Across oral agent treatment categories, the proportion with HbA1c controlled at the 7.0 level was significantly lower (p<0.01) for those on triple therapy (31.9%) (TZD, sulfonylurea, and metformin), than those on metformin alone (62.2%), likely reflecting a progressive treatment approach of prescribing additional medications for those with uncontrolled HbA1c levels. Conclusions: Use of multiple oral agents among adults with type 2 diabetes has increased (sulfonylurea and metformin, p = 0.03, triple therapy, p = 0.02). However, nearly half of adults with type 2 diabetes have HbA1c levels above ADA guidelines for control, indicating that available treatments could be used more optimally, and new diabetic agents may be needed.
KW - Glucose control
KW - HbA
KW - NHANES
KW - Prescription medication
KW - Treatment
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=67650472212&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67650472212&partnerID=8YFLogxK
U2 - 10.1185/03007990902973300
DO - 10.1185/03007990902973300
M3 - Article
C2 - 19469695
AN - SCOPUS:67650472212
VL - 25
SP - 1605
EP - 1613
JO - Current Medical Research and Opinion
JF - Current Medical Research and Opinion
SN - 0300-7995
IS - 7
ER -