Control of Glucose, Blood Pressure, and Cholesterol among Adults with Diabetes: The Brazilian National Health Survey

J Clin Med. 2021 Jul 31;10(15):3428. doi: 10.3390/jcm10153428.

Abstract

ABC (glucose, blood pressure and LDL-cholesterol) goals are basic standards of diabetes care. We aimed to assess ABC control and related factors in a representative sample of Brazilian adults with diabetes. We analyzed 465 adults with known diabetes in the Brazilian National Health Survey. The targets used were <7% for glycated hemoglobin (A1C); <140/90 mmHg for blood pressure; and <100 mg/dL for LDL-C, with stricter targets for the latter two for those with high cardiovascular (CVD) risk. Individual goals were attained by 46% (95% CI, 40.3-51.6%) for A1C, 51.4% (95% CI, 45.7-57.1%) for blood pressure, and 40% (95% CI, 34.5-45.6%) for LDL-C. The achievement of all three goals was attained by 12.5% (95% CI, 8.9-16.2%). Those with high CVD risk attained blood pressure and LDL-C goals less frequently. A1C control improved with increasing age and worsened with greater duration of diabetes. Achievement of at least two ABC goals decreased with increasing BMI and greater duration of diabetes. In sum, about half of those with known diabetes achieved each ABC goal and only a small fraction achieved all three goals. Better access and adherence to treatment and strategies to personalize goals according to specific priorities are of the essence.

Keywords: LDL cholesterol; blood pressure; diabetes mellitus; glucose control; measuring quality of diabetes care.