“These are concerning findings. There has been a real decline in glycemic control from a decade ago, and overall, only a small proportion of people with diabetes are simultaneously meeting the key goals of glycemic control, blood pressure control, and control of high cholesterol,” senior author Elizabeth Selvin, Ph.D., a professor in the Bloomberg School’s Department of Epidemiology said in a press release.
The study also showed a 22.2% decrease in adults controlling blood sugar, blood pressure and cholesterol between 2015 and 2018. That’s down from 24.9% from 2007-2010.
According to Selvin, the ACCORD and ADVANCE trials results could explain the trends. They showed rapidly decreasing HbA1c, a measure of blood sugar control over three months, to extremely low levels did not achieve expected cardiovascular benefits. An increased risk of low blood sugar was found in some trial participants who had blood sugar controlled to very low levels.
“As a result of these trials, what we may be seeing is that doctors of people with diabetes may have backed off a bit on glycemic control, with potentially damaging results,” Selvin said. New medication for managing HbA1c may have been developed since that time, she noted.
She added that across the nation, blood pressure control has decreased. Blood pressure results in the study’s participants seem to follow that general trend.