Achievement of American Diabetes Association Clinical Practice Recommendations Among U.S. Adults With Diabetes, 1999–2002

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Abstract
OBJECTIVE—To estimate the proportion of U.S. adults with diabetes who meet American Diabetes Association (ADA) clinical practice recommendations. RESEARCH DESIGN AND METHODS—Using data from the 1999–2002 National Health and Nutrition Examination Survey, 998 adults aged ≥18 years with self-reported diabetes were identified. The proportion of adults with diabetes meeting ADA recommendations for HbA1c (A1C), HDL cholesterol, LDL cholesterol, triglycerides, blood pressure, renal function, nutrient intake, smoking, pneumococcal vaccination, and physical activity was estimated. RESULTS—Among U.S. adults with diabetes in 1999–2002, 49.8% had A1C 81% of the sample reported not smoking at the time of the exam, only 38.2% reported ever having had a pneumococcal immunization, and 28.2% reported getting the recommended level of physical activity. Race, age, duration of diabetes, and education affected achievement of ADA recommendations. CONCLUSIONS—Achievement of ADA clinical practice recommendations is far from adequate in U.S. adults with diabetes.