Suboptimal control of glycemia, blood pressure, and LDL cholesterol in overweight adults with diabetes: the Look AHEAD Study

J Diabetes Complications. Jan-Feb 2008;22(1):1-9. doi: 10.1016/j.jdiacomp.2006.10.003.

Abstract

Background: The characteristics associated with meeting goals for glycemia, blood pressure (BP), and low-density lipoprotein (LDL) cholesterol for participants with diabetes were examined.

Methods: Baseline information on demographics, medical history, and anthropometry, as well as on hemoglobin A1c, BP, and LDL cholesterol levels, was measured in 5145 participants of Look AHEAD, a multicenter randomized trial performed to determine whether long-term weight loss and increased physical fitness reduce cardiovascular disease (CVD) in overweight and obese individuals with type 2 diabetes. Logistic regression was used to analyze these cross-sectional data to ascertain associations between participant characteristics and attainment of risk factor goals [hemoglobin A1c <7.0%, BP <130/80 mmHg, and LDL <100 mg/dl].

Results: The study population had a mean age of 58.7 years and a mean body mass index of 36.0 kg/m(2). Of the total number of participants, 59.5% were female, 36.8% were of ethnic/racial minority, and 87.3% were on diabetes medications. Upon enrollment, 45.8% had hemoglobin A1c<7.0%, 51.7% had BP<130/80 mmHg, and 37.2% had LDL<100 mg/dl. All three goals were met by only 10.1%. We found consistent evidence for differences in risk factor control by age, gender, race/ethnicity, degree of obesity, education, income, CVD, source of medical care, and medication use. In multivariable analysis, African-American race, increasing degree of obesity, insulin use, and nonutilization of a lipid-lowering agent were associated with not meeting all risk factor goals.

Conclusion: These data demonstrate that numerous baseline characteristics are associated with suboptimal control of these cardiovascular risk factors among overweight and obese adults with diabetes.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Blood Glucose / metabolism*
  • Blood Pressure / physiology*
  • Cardiovascular Diseases / etiology
  • Cholesterol, LDL / blood*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / metabolism*
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hypercholesterolemia / physiopathology
  • Hypercholesterolemia / therapy
  • Hyperglycemia / physiopathology
  • Hyperglycemia / therapy
  • Hypertension / physiopathology
  • Hypertension / therapy
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity / complications*
  • Obesity / ethnology
  • Obesity / metabolism*
  • Physical Fitness / physiology
  • Risk Factors
  • Weight Loss / physiology

Substances

  • Blood Glucose
  • Cholesterol, LDL
  • Glycated Hemoglobin A