Improvements in risk factor control among persons with diabetes in the United States: evidence and implications for remaining life expectancy

Diabetes Res Clin Pract. 2009 Dec;86(3):225-32. doi: 10.1016/j.diabres.2009.09.017. Epub 2009 Oct 14.


Aims: To examine whether A1c, blood pressure, and cholesterol values changed for U.S. adults with diagnosed diabetes between 1988-1994 and 2005-2006. We then project the impact of these changes on life expectancy and diabetes-related complications.

Methods: We estimated changes in hemoglobin A1c, blood pressure, and total cholesterol between 1988-1994 and 2005-2006 using regression analysis and data from the National Health and Nutrition Examination Survey. We projected the potential effects on life expectancy and complications using the CDC-RTI Diabetes Cost-Effectiveness Model.

Results: A1c fell by 0.68 percentage points (P=0.001) among U.S. adults with diagnosed diabetes. Among those with diabetes and hypertension, systolic and diastolic blood pressure fell by 5.66 and 8.15mmHg, respectively (P=0.005 and P=0.001). Among those with diabetes and high cholesterol, total cholesterol fell by 36.41mg/dL (P=0.001). These improvements were projected to increase life expectancy for persons with newly diagnosed diabetes by 1.0 year.

Conclusions: Risk factor control has improved in the United States. Persons newly diagnosed with type 2 diabetes in 2005 have a better prognosis than persons diagnosed with diabetes 11 years earlier.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Pressure
  • Cholesterol / blood
  • Diabetes Complications / epidemiology*
  • Diabetes Complications / prevention & control
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / physiopathology
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / prevention & control
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Hypertension / epidemiology
  • Incidence
  • Life Expectancy*
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Regression Analysis
  • Risk Factors
  • Risk Management / methods*
  • United States / epidemiology
  • Young Adult


  • Glycated Hemoglobin A
  • Cholesterol