Miranda Hitti

April 3, 2006 -- Diabetes care in the U.S. is improving, but not as much as experts would like.

"Overall, quality of care for people with diabetes has improved in the past 10 years, but important opportunities remain for further improvement," write the CDC's Jinan Saadine, MD, and colleagues in the Annals of Internal Medicine.

Saadine's team studied data collected from two national surveys. The surveys included U.S. adults aged 18-75 with diabetes in 1988-2002.

The researchers checked whether diabetes care changed during that time. Benchmarks included blood sugar and cholesterol control, blood pressure control, eye and foot exams, flu vaccination, and aspirin use to lower heart risks.

Study's Findings

The surveys showed improvements in diabetes care including:

• Better cholesterol control
• Increased use of eye and foot exams
• Rise in flu vaccinations
• Better self-monitoring of blood sugar level
• Increased aspirin use

Those changes are "encouraging," write Saadine and colleagues. But they note that the findings weren't totally rosy. For instance, blood pressure didn't improve, and no major shift was seen in blood sugar control.

The researchers report that:

• 2 in 5 diabetes patients still have poor LDL 'bad' cholesterol control.
• 1 in 3 still has poor blood pressure control.
• 1 in 5 still has poor blood sugar control.

The statistics don't include women with gestational diabetes, which can occur during pregnancy.

Diabetes Rising

Nearly 21 million people in the U.S. have diabetes. That number is projected to reach 39 million by 2050, the researchers note.

"Ensuring access to and delivering high-quality care for all people with diabetes should be a national priority," write Saadine and colleagues.

A journal editorial states that the study's main finding is that "millions of Americans remain at high risk for the complications of diabetes despite the new evidence and campaigns to educate the public and the medical profession."

The editorialists agree with Saadine's team that America needs to step up its diabetes care.

"If we succeed, we will improve the prospect of healthier lives for tens of millions of Americans," write the editorialists. They included Jonathan Perlin, MD, PhD, MSHA, of the U.S. Department of Veterans Affairs.

SOURCES: Saadine, J. Annals of Internal Medicine, April 4, 2006; vol 144: pp 465-474. Perlin, J. Annals of Internal Medicine, April 4, 2006; vol 144: pp 525-527. News release, American College of Physicians.

Reviewed by Louise Chang