Achievement of management targets associated with incident and long-term diagnosed diabetes among a representative population sample

Abstract

<h4>Aim</h4>To assess achievement of management targets among participants with diagnosed diabetes.<h4>Methods</h4>Participants in the North West Adelaide Health Study (n=4060), a representative cohort aged 18+ years, were assessed at baseline in 2000-03 and follow-up in 2004-06. Diagnosed and undiagnosed diabetes were determined from fasting plasma glucose (> or =7.0 mmol/L) and self-reported data.<h4>Results</h4>Baseline prevalences were 5.6% (95% CI 4.9-6.3) diagnosed and 1.0% (95% CI 0.7-1.4) undiagnosed diabetes. Annual incidences were 5.1 per 1000 diagnosed and 1.7 per 1000 undiagnosed diabetes. Among those with long-term diagnosed diabetes, 45.8% had HbA1c< or =7.0%, 26.8% had blood pressure<130/85 mmHg, 14.1% had body mass index< or =25, 88.5% were non- or ex-smokers, 19.2% had total cholesterol<4 mmol/L, 61.9% had triglycerides<2.0 mmol/L, 83.0% had HDL> or =1.0 mmol/L, and 45.6% had LDL<2.5 mmol/L. Participants with incident diagnosed diabetes were more likely to achieve HbA1c and less likely to achieve LDL targets than those with long-term diagnosed diabetes. Few people treated with hypoglycaemics, antihypertensives or statins were achieving targets.<h4>Conclusions</h4>Many people with diabetes are at risk of developing or worsening complications because they are not meeting recommended targets. Treatment with medication is also suboptimal, indicating a continued role for public health programs to reduce risk factors.