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Diabetes care improves, but results with insulin seem to lag

Our continually ongoing National Health and Nutrition Examination Surveys (NHANES) provide us with the most accurate picture of population-based diabetes control. NHANES A1C results have shown steady improvement over the last 25 years. This article looks at medication use over this time period, showing that most of the A1C improvements have come from people taking only oral agents. This group has increased as fewer individuals are treated with lifestyle only. What has remained surprisingly steady is the percentage of people taking insulin, and the percent of insulin taking individuals who have A1Cs under 8.0%. There has been an increase in the average duration of diabetes in those taking insulin, which again probably reflects the increased use and efficacy of oral agents.
Improving A1C results in people with type 2 diabetes taking insulin seems solvable, especially for those taking only basal insulin, but these data show that the solution for the general population hasn’t been found.
See abstract here.

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