Abstract 18450: Inadequate Control of Cardiovascular Risk Factors and Prevalence of Comorbidities in Insulin and Non-Insulin Treated and Untreated Subjects with Type 2 Diabetes in the United States 2003-2006
Objective: The extent of cardiovascular disease (CVD) comorbidities and status of CVD risk factor control in Type 2 diabetes (T2DM) overall and according to insulin use status has not been recently described on a population level. We examined these issues in U.S. adults with T2DM.
Methods: In the cross-sectional National Health and Nutrition Examination Survey 2003-2006, we studied 889 subjects (projected by sample weighting to 14.3 million) with T2DM (based on age of diagnosis ≥ 30 years) mean age 64.1 years, 54% women, 14% Hispanic and 18% non-Hispanic Black, of which 23% were insulin users, 47% on oral diabetics only, and 20% not on diabetes medications. We determined the prevalence of CVD co-morbidities and proportion of subjects not at goal for blood pressure (BP), lipids, glycosylated hemoglobin (A1c) and other cardiometabolic risk factors according to treatment status.
Results: The table below shows the extent of control of A1c, BP, lipids and other measures, including CVD comorbidities according to diabetes medication status. Insulin-treated subjects were more likely than other T2DM subjects to not be controlled for A1c or triglycerides, were more likely to be obese and with pre-existing CVD, chronic kidney disease (CKD) or macroalbuminuria. Only 10% overall were at goal for A1c, BP, and LDL-C, with a lower proportion of insulin-treated versus non-insulin treated subjects at this composite goal (table).
Conclusions: Many U.S. adults with T2DM, and in particular those taking insulin, remain inadequately controlled for A1c, BP, obesity and lipids. CVD and CKD are common, especially among insulin users. Greater efforts are needed to control CVD risk factors in those with T2DM, particularly among insulin users, to prevent their excess of CVD-related co-morbidities.
- © 2010 by American Heart Association, Inc.