Among U.S. Adults Diagnosed With Type 2 Diabetes A preliminary report

OBJECTIVE — To describe the changes in demographics, antidiabetic treatment, and glyce-mic control among the prevalent U.S. adult diagnosed type 2 diabetes population between the National Health and Nutrition Examination Survey (NHANES) III (1988–1994) and the initial release of NHANES 1999–2000. RESEARCH DESIGN AND METHODS — The study population was derived from NHANES III (n 1,215) and NHANES 1999–2000 (n 372) subjects who reported a diagnosis of type 2 diabetes with available data on diabetes medication and HbA1c. Four therapeutic regimens were defined: diet only, insulin only, oral antidiabetic drugs (OADs) only, or OADs plus insulin. Multiple logistic regression was used to examine changes in antidiabetic regimens and glycemic control rates over time, adjusted for demographic and clinical risk factors. The outcome measure for glycemic control was HbA1c. Glycemic control rates were defined as the proportion of type 2 diabetic patients with HbA1c level 7%. RESULTS — Dietary treatment in individuals with diabetes decreased as the sole therapy from 27.4 to 20.2 % between the surveys. Insulin use also decreased from 24.2 to 16.4%, while those on OADs only increased from 45.4 to 52.5%. Combination of OADs and insulin increased fro