Résumé :
|
[BDSP. Notice produite par INIST-CNRS R0x5Iw6o. Diffusion soumise à autorisation]. Context : Control of blood glucose levels, blood pressure, and cholesterol levels is proven to reduce the risk of vascular disease among individuals with diabetes mellitus ; however, the current state of control of these risk factors among individuals in the United States is uncertain. Objectives : To examine 1999-2000 national data on control of risk factors for vascular disease among adults with previously diagnosed diabetes and to assess trends during the past decade. Design, Setting, and Participants : Review of data from the Third National Health and Nutrition Examination Survey (NHANES III, conducted 1988-1994) and NHANES 1999-2000, cross-sectional surveys of a nationally representative sample of the non-institutionalized civilian US population. Participants were adults aged 20 years and older with previously diagnosed diabetes who participated in both the interview and examination in either NHANES III (n=1265) or NHANES 1999-2000 (n=441). Main Outcome Measures : Levels of glycosylated hemoglobin (HbA1c), blood pressure, and total serum cholesterol in reference to target goals. Results : Compared with NHANES III, participants with previously diagnosed diabetes in NHANES 1999-2000 were similar by age and sex, were less likely to be non-Hispanic white, were diagnosed at an earlier age, had a higher body mass index, and were more likely to use insulin in combination with oral agents. In NHANES 1999-2000, only 37.0% of participants achieved the target goal of HbA1c level less than 7.0% and 37.2% of participants were above the recommended "take action" HbA1c level of greater than 8.0% ; these percentages did not change significantly from NHANES III (P=11 and P=87, respectively). Only 35.8% of participants achieved the target of systolic blood pressure (SBP) less than 130 mm Hg and diastolic blood pressure (DBP) less than 80 mm Hg, and 40.4% had hypertensive blood pressure levels (SBP>=140 or DBP>=90 mm Hg). These percentages did not change significantly from NHANES III (P=10 and P=56, respectively). Over half (51.8%) of the participants in NHANES 1999-2000 had total cholesterol levels of 200 mg/dL or greater (vs 66.1% in NHANES III ; P<. in total only confidence interval of adults with diabetes nhanes attained recommended goals hba1c level less than blood pressure mm hg and cholesterol mg mmol conclusion : further public health efforts are needed to control risk factors for vascular disease among individuals diagnosed diabetes.>
|