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Control of Risk Factors Among People With Diagnosed Diabetes, by Lower Extremity Disease Status
Preventing Chronic Disease, 09/16/09

Dorsey RA et al. – Control of 2 of 6 modifiable risk factors was worse in diabetic adults with lower extremity disease (LED) compared with diabetic adults without LED. Among diabetic people with LED, non–Hispanic blacks had worse control of 3 of 6 risk factors compared with non–Hispanic whites.

Methods

The sample from the 1999–2004 National Health and Nutrition Examination Survey – 948 adults aged 40 years or older with diagnosed diabetes and who had been assessed for lower extremity disease (LED).
LED was defined as peripheral arterial disease (ankle–brachial index <0.9), peripheral neuropathy (>=1 insensate area), or presence of foot ulcer.
Good control of modifiable risk factors included being a nonsmoker and having the following measurements: hemoglobin A1c (HbA1c) less than 7%, systolic blood pressure less than or equal to 130 mm Hg, diastolic blood pressure less than or equal to 80 mm Hg, high–density lipoprotein (HDL) cholesterol greater than 50 mg/dL, and body mass index (BMI) between 18.5 kg/m2 and 24.9 kg/m2.

Results

Diabetic people with LED were less likely than were people without LED to have recommended levels of HbA1c (39.3% vs 53.5%) and HDL cholesterol (29.7% vs 41.1%), but there were no differences in systolic or diastolic blood pressure, BMI classification, or smoking status between people with and without LED.
Control of some risk factors differed among population subgroups. Notably, among diabetic people with LED, non–Hispanic blacks were more likely to have improper control of HbA1c, systolic blood pressure, and diastolic blood pressure, compared with non–Hispanic whites.

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