Achievement of management targets associated with incident and long-term diagnosed diabetes among a representative...

To assess achievement of management targets among participants with diagnosed diabetes.

Participants in the North West Adelaide Health Study (n=4060), a representative cohort aged 18+ years, were assessed at baseline in 2000-03 and follow-up in 2004-06. Diagnosed and undiagnosed diabetes were determined from fasting plasma glucose (> or =7.0 mmol/L) and self-reported data.

Baseline prevalences were 5.6% (95% CI 4.9-6.3) diagnosed and 1.0% (95% CI 0.7-1.4) undiagnosed diabetes. Annual incidences were 5.1 per 1000 diagnosed and 1.7 per 1000 undiagnosed diabetes. Among those with long-term diagnosed diabetes, 45.8% had HbA1c< or =7.0%, 26.8% had blood pressure<130/85 mmHg, 14.1% had body mass index< or =25, 88.5% were non- or ex-smokers, 19.2% had total cholesterol<4 mmol/L, 61.9% had triglycerides<2.0 mmol/L, 83.0% had HDL> or =1.0 mmol/L, and 45.6% had LDL<2.5 mmol/L. Participants with incident diagnosed diabetes were more likely to achieve HbA1c and less likely to achieve LDL targets than those with long-term diagnosed diabetes. Few people treated with hypoglycaemics, antihypertensives or statins were achieving targets.

Many people with diabetes are at risk of developing or worsening complications because they are not meeting recommended targets. Treatment with medication is also suboptimal, indicating a continued role for public health programs to reduce risk factors.