Glycemic control of older adults with type 2 diabetes: Findings from the Third National Health and Nutrition Examination Survey, 1988-1994

BACKGROUND: Although nearly half of all people who have diabetes are aged 6 5 or older, glycemic control of older adults with diabetes has nor been wel l described. METHODS: We conducted a cross-sectional study of 1,482 participants with se lf-reported type 2 diabetes in the Third National Health and Nutrition Exam ination Survey, 1988-1994 (NHANES III), a nationally representative sample of the US noninstitutionalized civilian population. Variables included in t his analysis included age, sociodemographic factors, drug treatment, and le vel of glycemic control. RESULTS: The mean % (+/-SE) HbA(1c) was 7.78 +/- 0.21, 7.64 +/- 0.18, 7.71 +/- 0.14, and 7.27 +/- 0.14 in persons aged 20 to 54, 55 to 64, 65 to 74 an d greater than or equal to 75 years, respectively. The mean mg/dL (+/-SE) f asting plasma glucose (FPG) was 175.9 +/- 7.6, 164.5 +/- 6.1, 183.3 +/- 5.3 , and 158.5 +/- 5.5 in the four age groups and older, respectively. When co ntrolling for race, gender, education, and duration of diabetes, age was no t significantly associated with levels of HbA(1c) [P (trend) = 0.17] or FPG [P (trend) = 0.19]. Among NHANES III participants aged 65 or older, ADA guidelines for glycemic control (HbA(1c) < 7%) were achieved by 71%, 44%, and 27% of persons using no drug therapy, oral hypoglycemic agents, and insulin, respectively. CONCLUSIONS: Although many older adults with type 2 diabetes do not achieve targets for glucose control, there is no evidence to suggest that communit y-dwelling older adults with diabetes are treated less vigorously than youn ger persons with diabetes.