Achievement of Glycated Hemoglobin Goals in the US Remains Unchanged Through 2014

Abstract

IntroductionPrevious research has found that the percentage of US adults with diabetes achieving a glycated hemoglobin (HbA1c) target of <7.0% with currently available treatments has been fairly constant from 2003 to 2010, remaining at just over 50% [1]. The objective of this study was to compare the most recent data (2011–2014) with earlier data to track progress on HbA1c target achievement, for both the general target of <7.0% and inferred individualized targets based on age and the presence of complications.MethodsData from 2677 adults with self-reported diabetes from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014 were examined to determine the percentage of adults who achieved HbA1c targets of <7% and an individualized target based on age and comorbidities. National estimates are reported by using weights that account for the complex sampling design of the NHANES.ResultsThe percentage of people with diabetes and HbA1c <7.0% slightly declined from 52.2% (95% CI 48.7–55.7%) to 50.9% (95% CI 47.2–54.7%) between the two most recent waves of data. Achievement of individualized targets declined from 69.8% (95% CI 66.5–73.0%) to 63.8% (95% CI 60.1–67.5%). The percentage with HbA1c >9.0% increased from 12.6% (95% CI 10.5–14.8%) to 15.5% (95% CI 12.9–18.2%). Achievement of individualized targets varied by age group and presence of comorbidities, but exhibited similar trends as general target achievement.ConclusionsDespite the development of many new medications to treat diabetes during the past decade, the proportion of patients achieving glycemic control targets has not improved.FundingIntarcia Therapeutics.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0280-5) contains supplementary material, which is available to authorized users.

Improved treatment satisfaction in patients with type 2 diabetes treated with once‐weekly semaglutide in the SUSTAIN trials

“…Despite the availability of effective glucose‐lowering agents, many patients with type 2 diabetes (T2D) do not achieve glycaemic targets . Adherence to and persistence with treatment regimens are important factors for treatment effectiveness .…”

“…glucagon-like peptide-1 analogue, hypoglycaemia, incretin therapy, type 2 diabetes, weight control 1 | INTRODUCTION Despite the availability of effective glucose-lowering agents, many patients with type 2 diabetes (T2D) do not achieve glycaemic targets. [1][2][3] Adherence to and persistence with treatment regimens are important factors for treatment effectiveness. 4 Higher treatment satisfaction has been associated with better treatment adherence and improved persistence.…”

Treatment satisfaction with ITCA 650, a novel drug‐device delivering continuous exenatide, versus twice‐daily injections of exenatide in type 2 diabetics using metformin

“…However, medication efficacy is not the sole determinant of glycaemic control. Epidemiological surveys have reported that the percentage of patients achieving HbA1c reduction <7% has remained virtually unchanged over the past decade, despite the approval of over 40 new treatments (new classes and combination products) for T2D during this time period . Although the efficacy of these drugs has been demonstrated in randomized controlled trials, the uses of these medications under real world conditions often do not achieve optimal efficacy.…”

“…When patients were analysed based on the presence or absence of N/V, there were significant improvements from baseline (P < .01) in each group for all DM-SAT scores to Week 8 (Table S4) [35][36][37][38] Although the efficacy of these drugs has been demonstrated in randomized controlled trials, the uses of these medications under real world conditions often do not achieve optimal efficacy. Lack of adherence has been identified as a significant factor in contributing to poorer glycaemic control under real world conditions.…”

What are we treating with antihyperglycaemic drug therapy?

“…Scientific evidence from clinical trials has shown that mono‐, dual‐ and triple‐medication regimens effectively and incrementally lower A1C by up to 1% point respectively . However, this efficacy has not translated to the average patient population because only about 50 and 64% of American adults achieved an A1C <7% and individualised A1C goals respectively from 2003 through 2014 …”