Skip to content
My WebMD Sign In, Sign Up

Diabetes Health Center

Font Size

U.S. Diabetes Control Dangerously Poor

2/3 of Patients Don't Meet Glucose Control Targets
By
WebMD Health News

May 18, 2005 -- Two-thirds of patients with type 2 diabetes do not adequately control their blood sugar, leaving millions of U.S. patients vulnerable to the disease's complications, according to a report released Wednesday.

Experts caution that the results show a dangerous lack of attention from both doctors and the estimated 13.8 million Americans diagnosed with diabetes.

The recommendations by the American Association of Clinical Endocrinologists for managing blood sugars set a limit for a measure known as hemoglobin A1c. Experts consider the test the most important measure of a diabetic person's blood glucose control because it estimates an average blood sugar level over a two- to three-month period.

Studies have shown that the risk of complications in people with type 2 diabetes -- including nerve damage, blindness, and kidney failure -- all increase as hemoglobin A1c goes up.

But Wednesday's report, based on health records of 157,000 patients with diabetes, showed that 67% of people with type 2 diabetes have A1c scores exceeding 6.5%, a limit laid down in the group's recommendations. Not one of 39 states surveyed had more than half its diabetic population under the limit, it concludes.

The top 10 states with the worst diabetes control were:

1. Mississippi
2. Illinois
3. Utah
4.Ohio
5. Alabama
6. Louisiana
7. New York
8. Pennsylvania
9. Arkansas
10. West Virginia

"I think we need to get serious," says Jaime A. Davidson, MD, a clinical associate professor of internal medicine at the University of Texas Southwestern Medical School in Dallas. "I want to tell you, none of us are doing well."

"The report, I think, is sobering. The key message to me is that this is a national problem," says Lawrence Blonde, MD, a member of the American Association of Clinical Endocrinologists board of directors.

"What's A1c?"

Another study performed by the group suggests that widespread lack of awareness of the hemoglobin A1c tests may be partly to blame for the poor scores, Blonde says. Six in 10 diabetic people in an April 2004 survey were unaware of the test, while half of those who were aware of it did not know their latest score.

The national survey was financed by GlaxoSmithKline, a pharmaceutical company that makes medications used by people with type 2 diabetes. GlaxoSmithKline is a WebMD sponsor.

Paul S. Jellinger, MD, president of the American College of Endocrinology, tells WebMD that doctors should strive to make A1c a household word among diabetes patients and people at risk for the disease. "It needs to be driven home to both physicians and patients," he says.

"Patients need to ask for [the A1c test] just like they ask, 'What is my cholesterol?'" he says.

Mississippi ranked at the bottom of 39 states in the nationwide survey, with 72.8% of its diabetic adults above the 6.5% A1c target. Montana was best with 55.2% above the goal.

Of 10 states measuring percentages of people with type 2 diabetes at levels above 9%, New Hampshire scored best.

Is This Normal? Get the Facts Fast!

Check Your Blood Sugar Level Now
What type of diabetes do you have?
Your gender:

Get the latest Diabetes newsletter delivered to your inbox!


or
Answer:
Low
0-69
Normal
70-130
High
131+

Your level is currently

If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Did You Know Your Lifestyle Choices
Affect Your Blood Sugar?

Use the Blood Glucose Tracker to monitor
how well you manage your blood sugar over time.

Get Started

This tool is not intended for women who are pregnant.

Start Over

Step:  of 

Today on WebMD

Woman holding cake
Slideshow
feet
Slideshow
 
man organizing pills
Slideshow
Close up of eye
Slideshow
 

Woman serving fast food from window
Video
Can Vinegar Treat Diabetes
Video
 
Middle aged person
Tool
are battery operated toothbrushes really better
Video
 

Prediabetes How to Prevent Type 2 Diabetes
Article
type 2 diabetes
Slideshow
 
food fitness planner
Tool
Are You at Risk for Dupuytrens Contracture
Article