Abstract Background Diabetes is a leading cause of morbidity and mortality in the United States. We aimed to characterize secular trends in diabetes prevalence, control of glucose and associated comorbidities, and medication use. Methods This was a retrospective analysis of National Health and Nutrition Examination Series data from 2001 to 2023. We focused on three outcomes: (1) prevalence of diabetes defined by known diagnosis, hemoglobin A1c ≥ 6.5%, or fasting glucose ≥ 126 mg/dL, and among individuals with diabetes (2) control of glucose levels, low-density lipoprotein, and blood pressure and (3) medication therapy. Predictors were cycle (year) and demographics, specifically age, sex, race/ethnicity, educational level, and household income. Results We included 27,437 participants of whom 3467 had diagnosed diabetes and an additional 1602 had undiagnosed diabetes. Diabetes prevalence increased from 10.0% in 2001–2002 to 15.1% in 2021–2023 and was higher in men versus women, and Hispanic/Latino or non-Hispanic Black vs. non-Hispanic White participants. Glycemic control declined over time, from 61.5 to 44.9% having hemoglobin A1c < 7% in 2001–2002 vs. 2021–2023; control was lower in younger participants and those with lower educational attainment. Lipid control improved over time but remained poor: 73.1% had low-density lipoprotein ≥ 70 mg/dL in 2017–2020, and only half of these individuals were taking a statin. There were no significant changes over time in blood pressure control, with 44–56% having blood pressure ≥ 130/80 mmHg. Other than lower lipid control in women, we did not observe differences in control of lipids or blood pressure, or in medication treatment, based on sex and race/ethnicity. Discussion Diabetes has increased in prevalence from 2001 to 2023 and management of hyperglycemia and associated risk factors remains inadequate.
Hu et al. (Wed,) studied this question.