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01-09-2011 | Diabetes | Article

Smoking, obesity hinder CVD risk control in US diabetics


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MedWire News: Substantial progress has been made in the control of key risk factors for cardiovascular disease (CVD) among adults with diabetes in the United States, research shows.

However, this achievement has been marred somewhat by a lack of a progress in reducing the prevalence of smoking and obesity.

As reported in the Journal of Diabetes, Earl Ford (Centers for Disease Control and Prevention, Atlanta, Georgia, USA) analyzed data for 2623 diabetic adults (aged 20 years or above) who participated in 2-year cycles of the National Health and Nutrition Examination Surveys (NHANES) between 1999 and 2008.

During each consecutive 2-year cycle, a national sample was recruited using a multistage, stratified design.

Similar to previous studies, control of glycated hemoglobin (HbA1c) levels, blood pressure (BP), and low-density lipoprotein (LDL) cholesterol were the principal focal points of this study.

However, "the present study also presents unique results on trends in risk factors such as smoking, body mass index (BMI), C-reactive protein, and microalbuminuria," says Ford.

The research revealed an improvement in the percentage of the study population with control of HbA1c (37.0% to 55.2%), blood pressure (35.2% to 51.0%), and LDL cholesterol (32.5% to 52.9%) levels.

Further analysis showed a significant increase in the prevalence of glycemic control among Whites (48.3% to 58.9%), African-Americans (36.5% to 49.8%) and Mexican Americans (36.7% to 47.6%).

However, there was little change in the prevalence of not currently smoking, having a C-reactive protein concentration below 3 g/l, and having a urinary albumin-creatinine ratio below 30 mg/g.

"It is disappointing to note that little progress in reducing the prevalence of current smokers was made from 1999 to 2008," says Ford.

The study also revealed that the proportion of overweight people (BMI ≥30 kg/m2 ) increased from 54.6% to 62.4%.

"Although the percentages of diabetic adults with controlled risk factors are important metrics to use in measuring progress in achieving control of risk factors, estimates of the numbers of diabetic adults with uncontrolled risk factors are vital metrics for the purposes of estimating economic costs as well as planning and resource allocation," writes Ford.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Sally Robertson