Effective diabetes management linked to lower HbA1c for US adults
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BALTIMORE — Healthy diabetes management behaviors, such as eating fewer calories, taking insulin and regularly checking feet, are associated with lower HbA1c, according to a presenter.
In findings from six National Health and Nutrition Examination Survey cycles presented at the Association of Diabetes Care and Education Specialists Annual Conference, researchers found associations between key components of diabetes management and HbA1c level, revealing the importance of diabetes management as well as the work of diabetes care and education specialists, according to Cherry Myung, MS, a program staff manager at Touro University California College of Osteopathic Medicine; and Clipper Young, PharmD, MPH, CDCES, an associate professor at Touro University California College of Osteopathic Medicine.
“Each of these significant findings points to a key component in diabetes management, reinforcing that continuous large-scale public health campaigns are needed to strengthen the existing messages to patients with diabetes for effective disease management,” Myung and Young told Healio.
Myung, Young and colleagues conducted a cross-sectional analysis of data collected from six NHANES cycles from 2007 to 2018. The analysis included 4,623 participants with diabetes and available HbA1c information who fully answered survey questions about diabetes care practices (average age, 62 years; 33.8% white, 26.9% Black, 17.4% Mexican American). Researchers analyzed associations between specific diabetes care practices and HbA1c level.
After adjusting for age, sex, race/ethnicity, education, health insurance and the ratio of income to poverty, adults who checked their feet were more likely than those who did not check their feet to have an HbA1c of less than 9% (adjusted OR = 1.679; 95% CI, 1.095-2.56). The researchers noted the association between checking feet and a lower HbA1c varied among NHANES cycles, however, with some cycles showing no association. Participants who reported seeing a diabetes specialist within the last year were less likely to have an HbA1c of less than 9% than those who last saw a diabetes specialist more than 1 year ago (aOR = 0.876; 95% CI, 0.824-0.931).
“When we are looking at a data set at a national level, the findings we see might not be always consistent with what we see in our everyday practice,” Myung and Young said.
Participants who reported reducing their intake of fat and calories were more likely to achieve an HbA1c of less than 9% than those who did not (aOR = 2.39; 95% CI, 1.25-4.55). Respondents who took insulin were more likely to have a HbA1c of less than 9% than non-insulin users (aOR = 32.45; 95% CI, 25-42.07).
Myung and Young said future research should involve further subgroup analyses, including examining associations within different NHANES cycles to identify trends and looking at associations within demographic subgroups.
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Myung C, et al. P118. Presented at: ADCES22; Aug. 12-15, 2022; Baltimore.
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