1627-P: Glycemic Control From 2013 to 2016 among U.S. Adults with Type 2 Diabetes (T2D): A National Estimate Stratified by Age, eGFR Category, and Comorbidities

The adequacy of adherence to ADA guidelines, as reflected in glycemic control, has not been assessed for the U.S. adult T2D population by different risk factors, such as age, CVD, obesity and eGFR categories. The aim of this study was to provide such estimates. Using NHANES 2013-2016 data, we conducted a cross-sectional analysis of an adult sample with diagnosed and undiagnosed T2D (n=1705), aged ≥ 18 years. We aggregated HbA_1c measures to 4 levels: <7%, 7-<8%, 8-<9%, and ≥9%. Appropriate sample weights were used to obtain national projections. Results of glycemic control stratified by age, eGFR categories and comorbidities in U.S. adults with T2D are presented in Table 1. The overall glycemic control rate, defined as HbA_1c <7%, was 51.9%. Among T2D aged 45-64 years, 46.6% had an HbA_1c <7%; while 60.3% of T2D aged ≥75 years had an HbA_1c <7%. Among T2D with renal impairment, the glycemic control rate was similar across eGFR categories, remaining at above 50%. Among T2D with different comorbidities, glycemic control rate ranged from 48.5% for those with both obesity and CVD to 69.5% for those with CVD only. Overall, 14.8% of T2D had an HbA_1c ≥9%, with 22.7% among aged 18-44 years and 20.3% among those with eGFR >90 ml/min/1.73m². Our data shows only about 50% of T2D patients are at HbA_1c goal of <7% with currently available treatments, ranging from 47-70% depending on risk factors.