Treatment and Control of Diabetes Mellitus in the United States National Health and Nutrition Examination Survey, 1999-2002

Control of glycemia and other risk factors in people with diabetes has a critical bearing on clinical outcome. Using data from the US National Health and Nutrition Examination Survey 1999-2002, the authors compared the characteristics and control among diabetic subjects in different antidiabetic treatment groups. Among diagnosed diabetic subjects (n=827), 18.3%, 15.2%, 56.6%, and 9.6% used diet therapy alone, insulin therapy alone, oral antidiabetic drugs alone, or both insulin and oral antidiabetic drugs, respectively. The pattern of antidiabetic treatment differed by age and race/ethnicity, but not sex and status of the cardiometabolic syndrome. Only a minority of patients had satisfactory control of glycemia (38.8%), low-density lipoprotein cholesterol (35.0%), and blood pressure (42.5%). Patients taking only insulin had the poorest glycemic control (15.2%), while patients using diet treatment alone (65.9%) had the best glycemic control. There is a need to improve glycemic control. Better patient education, intensive lifestyle changes, and newer therapies need to be explored.