Inadequate glycemic control among individuals with diabetes constitutes a major public health problem in the U.S. Uncontrolled diabetes is associated with premature death and disability as well as decreased quality of life and significantly adds to national medical health care expenditures. Recent estimates show that the minimum direct and indirect expenditures attributable to diagnosed diabetes in 2002 were $132 billion. Glycemic control remains the major therapeutic objective for prevention of target organ damage and other complications arising from diabetes. Studies have shown that a comprehensive and aggressive management approach is effective in decreasing the rate of progression of microvascular complications. Treatment regimens of diet and exercise, insulin, and oral hypoglycemic agents are known to improve glycemia, and current approaches to disease management that include greater patient self-participation are recommended.

However, the adequacy of adherence to American Diabetes Association guidelines, as reflected in estimates of glycemic control, have not been published recently for the U.S. population. A study of U.S. adults sampled from 1988 to 1994 reported that the glycemic control rate was only 44.6% among patients with diagnosed type 2 diabetes. Recently, the initial 1999–2000 National Health and Nutrition Examination Survey (NHANES) data have been released, providing an opportunity for further analysis. This report describes the changes in demographics, general drug treatment, and glycemic control among the prevalent U.S. adult diagnosed type 2 diabetes population between NHANES III (1988–1994) and NHANES 1999–2000.

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