Suboptimal control of glycemia, blood pressure, and LDL cholesterol in overweight adults with diabetes: the Look AHEAD Study

Alain G. Bertoni, Jeanne M. Clark, Patricia Feeney, Susan Z. Yanovski, John Bantle, Brenda Montgomery, Monika M. Safford, William H. Herman, Steven Haffner

Research output: Contribution to journalArticlepeer-review

62 Scopus citations

Abstract

Background: The characteristics associated with meeting goals for glycemia, blood pressure (BP), and low-density lipoprotein (LDL) cholesterol for participants with diabetes were examined. Methods: Baseline information on demographics, medical history, and anthropometry, as well as on hemoglobin A1c, BP, and LDL cholesterol levels, was measured in 5145 participants of Look AHEAD, a multicenter randomized trial performed to determine whether long-term weight loss and increased physical fitness reduce cardiovascular disease (CVD) in overweight and obese individuals with type 2 diabetes. Logistic regression was used to analyze these cross-sectional data to ascertain associations between participant characteristics and attainment of risk factor goals [hemoglobin A1c <7.0%, BP <130/80 mmHg, and LDL <100 mg/dl]. Results: The study population had a mean age of 58.7 years and a mean body mass index of 36.0 kg/m2. Of the total number of participants, 59.5% were female, 36.8% were of ethnic/racial minority, and 87.3% were on diabetes medications. Upon enrollment, 45.8% had hemoglobin A1c<7.0%, 51.7% had BP<130/80 mmHg, and 37.2% had LDL<100 mg/dl. All three goals were met by only 10.1%. We found consistent evidence for differences in risk factor control by age, gender, race/ethnicity, degree of obesity, education, income, CVD, source of medical care, and medication use. In multivariable analysis, African-American race, increasing degree of obesity, insulin use, and nonutilization of a lipid-lowering agent were associated with not meeting all risk factor goals. Conclusion: These data demonstrate that numerous baseline characteristics are associated with suboptimal control of these cardiovascular risk factors among overweight and obese adults with diabetes.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalJournal of Diabetes and Its Complications
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2008

Keywords

  • Blood pressure
  • Cholesterol
  • Hemoglobin A1c
  • Risk factor control

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