Blood glucose control disimproving despite technological advances

by | Jan 22, 2023 | Digital Health

According to a report by  JAMA Network Open, the percentage of type 2 diabetes patients whose blood sugar is under control has remained highly consistent over the past 30 years despite the availability of new technologies.
Researchers at Johns Hopkins University found that over these recent decades, the proportion of individuals with glycemic control decreased by just 1.7 percentage points, from 29.2% between 1988 and 1994 to 27.5% between 2013 and 2020, after analyzing data from the National Health and Nutrition Examination Survey (NHANES).
The study showed that rates of glycemic control disimproved among Mexican-American and non-Hispanic Black individuals while increasing in non-Hispanic white adults throughout the 30-year period as racial and ethnic differences increased.

Theoretically, since 1988, improvements in the formulation and delivery of insulin, along with new blood glucose monitoring devices, have made it simpler for patients with type 2 diabetes to manage their blood glucose levels. Although businesses have demonstrated gains in glycemic control in controlled clinical trials, it is unknown whether patients have actually experienced substantial advantages. The Johns Hopkins study analyzed NHANES data gathered across two time periods, 1988 to 1994 and 1999 to 2020, in an effort to remove that uncertainty. 2,482 people with diabetes who used insulin were included in the study.

The data revealed that between 2017 and 2020, 32.9% of non-Hispanic white adults achieved glycemic control, up from 27.7% between 1988 and 1994. However, throughout the same time period, rates of glycemic control in non-Hispanic Black adults and Mexican-American adults notably decreased, falling from 25.1% to 9.9% and from 31.8% to 22.9%, respectively. Glycemic control rates decreased generally. Why glycemic control rates decreased is unknown at present, however the researchers suggested the following three explanations: patients’ resistance to using insulin therapy as advised; delays in initiating or intensifying insulin therapy; and increased insulin prices that result in medication nonadherence. By making it simpler for patients to monitor their insulin therapy, medtech companies are already attempting to address some of the potential causes of low glycemic control rates. Novo Nordisk recently expanded its digital insulin initiation and titration app alliance in response to some of the difficulties patients confront.

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