A Diagnostics & Imaging Week

Over the last six years, Americans being treated for diabetes improved control of their disease by a significant 44.4%. As of December 2006, more than half, or 54.6% had reached treatment goals for glycemic control, according to the Quest Diagnostics Health Trends Report on Diabetes from Quest Diagnostics ( Lyndhurst, New Jersey).

The report, presented Saturday at the scientific sessions of the American Diabetes Association (Alexandria, Virginia), suggests that despite those overall gains, hemoglobin A1c values have plateaued since 2004, with 45% of patients in 2006 failing to reach treatment targets of HbA1c levels less than 7%.

A companion analysis of HbA1c tests revealed a significant seasonal variation in blood glucose control with HbA1c levels peaking in the winter and falling in the summer. These seasonal differences depend on the patient age and level of A1c control, but were most apparent in the elderly — greater than or equal to age 80 — and those with the highest levels of HbA1c , or at least 9% and above.

The report is based on findings from 22.7 million de-identified HbA1c tests, a key indicator of diabetes control, performed by Quest between 2001 and 2006 on 4.8 million patients who saw a healthcare professional and were classified as having diabetes.

The company said that the number of tests included in the study is more than 50 times that of other published reports on diabetes health.

“These data demonstrate incredibly significant improvements in diabetes management in the last six years, probably due to improved education, new medications and adherence to treatment guidelines,” said study co-author Francine Kaufman, MD, professor of pediatrics at the Keck School of Medicine, University of Southern California (Los Angeles), and past president of the ADA. “But more than 4 in 10 people with diabetes still fail to reach treatment goals, which indicates physicians and patients must continue to be committed to management of medication, physical activity, food intake and glucose monitoring.”

About 2.4 million diabetic foot ulcers are diagnosed each year in the U.S., many progressing to lower limb amputation. It is estimated that the U.S. healthcare costs for treating diabetic foot ulcers and related amputations exceed $10 billion per year.