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What percentage of diabetics achieve the guideline targets

pavlosn

pavlosn

Well-Known Member
Messages
2,705
Location
Cyprus
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Can anyone tell me what percentage of diabetics in the UK actually manage to maintain their glucose levels and A1C within the targets set by the guidelines? Any statistics available :?:

Just curious :!:

Regards

Pavlos
 
An interesting question,
On another forum a poster stated that the average was 9% but the poster gave no source so I looked it up. The official statistics are to be found here:
http://www.ic.nhs.uk/webfiles/Servi...eports/7121_National Diabetes Audit_final.pdf
The quote below is for English stats, in the report there is a similar section for Wales..with similar figures.
In 2007-2008 91 per cent of the records included an HbA1c measurement. In just over 60 per cent of the records HbA1c was ≤7.5 per centThus almost 40 per cent of people with diabetes have an HbA1c value in the increased risk range (>7.5 per cent) and 7.6 per cent had a very high risk HbA1c of >10 per cent.
Two thirds (66.59 per cent) of people with Type 2 diabetes but only one third (29.71 per cent) of people with Type 1 diabetes achieved the NICE recommended HbA1c target of ≤7.5 per cent.
Following the same trend as the previous audit year the achievement of the NICE HbA1c measurement of ≤7.5 per cent is higher in the older age bands peaking at 77 per cent in the 85+ year age band.
Click to expand...
The graphs in the reports also show the percentages with less than 6.5% and the Welsh figures are divided into age groups.
 
Dear Phoenix

Thanks for the info and the link. Interesting staff.

I note that while over 60% achieve the NICE target of 7.5% or lower only about 25% achieve A1C's of less or equal than 6.5%.

I also note that the there is a big differentiation in the scores achieved by different age groups:
0-5 year-olds: about 40% scored less than 7.5% and about 20% less than 6.5%
6-10 year-olds: about 27% scored less than 7.5% and about 4% less than 6.5%
11-15 year-olds: about 20% scored less than 7.5% and about 6% less than 6.5%
16-24 year-olds: about 18% scored less than 7.5% and about 6% less than 6.5%
24-39 year-olds: about 39% scored less than 7.5% and about 18% less than 6.5%
40-54 year-olds: about 50% scored less than 7.5% and about 20% less than 6.5%
55-69 year-olds: about 65% scored less than 7.5% and about 27% less than 6.5%
70-85 year-olds: about 72% scored less than 7.5% and about 30% less than 6.5%
85+ year-olds : about 77% scored less than 7.5% and about 43% less than 6.5%

The above results are combined results for both T1s, who probably form the majority of the younger age groups and T2s who probably form the majority of the older age groups. As the results for the two types vary significantly ((66.6% of T2s and about 30% of T1s achieve A1Cs of 7.5% or lower), it would have been useful to see separate aging analysis for T1s and T2s.

One conclusion I can arrive at based on the above data, is that the 5% club must be a very exclusive club indeed, !

Regards

Pavlos
 
The 5% club is not at all exclusive. It's always looking for new members and is delighted whenever any come forward
Hana
club member.5.3%
 
Just wanted to mention the ACCORD study in the US. Studied more than 10,000 ppl.
Intensive insulin therapy for T2 was deemed to be Hb1Ac <6% and normal T2 insulin therapy 7 to 7.9%. Over the life of the study 203 of the T2 7 to 7.9% ppl died and 257 of the T2 < 6% ppl. Over 50% of the excess deaths (as they phrased it) were from heart disease. The intensive insulin therapy part of the study was therefore stopped in Feb 2008
 
Dear Edwardia

Thanks for your contribution.

I guess I will have to research the Accord study.

I would be interested to see in what way the intensive treatment differed from the normal and any thoughts on what elements of the intensive treatment contributed to the "excess" deaths.

Also I wonder to what extent the results of the study, which dealt exclusively with T2 patients on insulin, apply to the rest of us, who try to control our condition through diet and oral mediction alone.

Reagrds

Pavlos
 
Just an alternative perspective. I don't want to achieve the target levels for a diabetic in the UK, which is around an HbA1c of 7%. Those levels are still toxic, in that those levels continue to damage your body, although at a slightly slower rate. I'm aiming for normal blood sugar and my current 7 day average from my meter is 5.5mmol.
 
Am a diabetic superstar then
T1, 3 out of 4 A1c's been in the 5's- am in top 29% of my field :lol:


Still, figures for uncontrolled are quite depressing - carbs anyone?
 
Edwardia said:
Just wanted to mention the ACCORD study in the US. Studied more than 10,000 ppl.
Intensive insulin therapy for T2 was deemed to be Hb1Ac <6% and normal T2 insulin therapy 7 to 7.9%. Over the life of the study 203 of the T2 7 to 7.9% ppl died and 257 of the T2 < 6% ppl. Over 50% of the excess deaths (as they phrased it) were from heart disease. The intensive insulin therapy part of the study was therefore stopped in Feb 2008
Click to expand...

Hi,

The ACCORD study has come up quite a lot; and is still raised as a reason not to lower one's HbA1c's by some health advisers.

Here is a response I did earlier:

The ACCORD study is a large U.S clinical study of adults with established Type 2 diabetes who are at especially high risk of cardiovascular disease.

Three treatment approaches were studied: (i) intensive lowering of blood sugar levels compared to a more standard blood sugar treatment;(ii) intensive lowering of blood pressure compared to standard blood pressure treatment; and (iii) treatment of blood lipids by a fibrate plus a statin compared to a statin alone.

Note, that the intensive lowering of blood sugars was not done by a low carbohydrate diet but was done by increased medication. Participants in the intensive group were more likely to be on combinations of drugs than participants in the standard group. For example, 52% of participants in the intensive strategy group were on three oral medications as well as insulin, compared to 16% of those in the standard group.

In its regular review of the available study data, the ACCORD DSMB noticed an unexpected increase in total deaths from any cause among participants who had been randomly assigned to the intensive blood sugar strategy group compared to those assigned to the standard blood sugar strategy group and stopped the intensive blood sugar strategy group element of the trial.

On the whole, the death rates in both blood sugar strategy groups were lower than those seen in similar populations. That is, although the death rate was higher in the intensive treatment group than the standard group, it was still lower than death rates reported in other studies of Type 2 diabetes.

The ACCORD participant treatment is scheduled to end in 2009, and researchers plan to report the final results in 2010.

[Source :U.S Department of Health & Human Services, National Heart Lung and Blood Institute web site - http://www.nhlbi.nih.gov/health/prof/he ... .htm#trial].

To sum up then; it is an ongoing Type 2 study, the increased mortality is related not to tighter control but to the manner in which the tighter control was attempted (i.e. high medication), the intensive blood sugar strategy group still had a better mortality rate than non-control Type 2 diabetics.

If anything this demonstrates that increased medication is the problem rather than tighter control.

It's rather like saying if I chop off my own leg with a chainsaw I will reduce my bodyweight (to the tune of one leg) but then bleed to death. Therefore, it is very dangerous to reduce one's bodyweight. Nope; it's very dangerous to use chainsaws as a means of weight reduction, just like it's dangerous to use high meds to reduce blood sugar levels.

Dillinger
 
cheers for this data, i have been wondering. i'm 22 so that makes me part of that 6%. no wonder so many DB get complications. instils me with some confidence i might be able to avoid them.
 
I don't think we should look at the Accord study in isolation, the following Advance study shows a different result.

Data from the ADVANCE Study, involving 11,140 high-risk patients with type 2 diabetes, provides no evidence of an increased risk of death among those patients receiving aggressive treatment to lower blood glucose.
Click to expand...

http://www.medicalnewstoday.com/articles/99074.php

Jenny points out the problems with Accord study.

http://diabetesupdate.blogspot.com/2009 ... those.html

Graham
 
kay957 said:
Mine is currently 7.1 is that ok or bad? the doctors tell me nothing :roll:
Click to expand...

The traget set for T2 diabetics by NICE is a maximum of 7.5% and obviously you fall within that.

However, non-diabetics have an HBA1C of at most 5.7%, and many people on this site aim to keep their levels as close to non-diabetic levels, as possible

I believe that studies have shown that , diabetics reduce their chances of developing serious long term complications such as blindness, kidney problems and stroke by something like 30 to 40 % for each 1% drop in HbA1C.

Things appear not so clear on whether there are benefits to be gained through intensive lowering of HbA1C in avoiding death from cardiovascular disease (the number one cause of death amongst diabetics).

For Type 1 diabetics it seems that by intensively lowering your HbA1C you improve your chances of getting cardiovascular complications as well.

It is for Type 2 diabetics that things seem to me more uncertain and controvertial. As you may have read in the previous posts, there are two studies which, although not yet completed, give conflicting results:

-The ACCORD study in the USA suggests that although intensive treatment to lower HbA1C below 6.5% reduces the chances of a diebetic having a heart attack, diabetcs on such an intensive treatment seem to have a lower chance of surviving a heart attack if they do have one.

- The ADVANCE study on the other hand confirms the reduction in the possibility of a heart attack through lowering of HbA1c, without finding increased possibility of fatal heart attacks.

Regards

Pavlos
 
my endo says its in older people that low hba1c's increase chance of heart attack etc. makes sense in that your heart can beat quite madly when ya BS is low.

howie
 
The ACCORD study is rubbish science.
What it atually proved was that if you control diabetes intensively with multiple medication in frequent doses, you hurt your patients.
the ADVANCE study is a much better planned study, which didn't bear out the ACCORD conclusions.
Hana
 
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