Continued Glycemic Control in Diabetes Patients – Data from the Israeli National Diabetes Register (INDR)

Background: Continued glycemic control has important clinical implications for prevention of long- term complications. Clinical data from the Israeli National Diabetes Register (INDR) enabled the analysis of long-term glycemic trends among diabetes patients.

Aim: To explore the rates of continued glycemic control (Hba1c≤7) and lack of control (Hba1c>9) among the diabetic population in Israel, as well as to examine the relationship between continued glycemic control and sociodemographic variables.

Methods: Five years of population-based data from the INDR (2012-2016, n=664,335). Data included HbA1c, age, gender and socioeconomic status (SES).

Patients with at least 3 years of follow-up were included.

Results: 473,212 individuals were included in the analysis, mean age 63.4 ±13.3, 50.5% were men and 70% had 5 years of follow-up. Annual HbA1c data was available for 73% of the included patients. Only 33% of the patients maintained glycemic control for the whole period (3-5 years), while 40% of the patients had at least one test result of HbA1c≤7 during that period. Rate of continued control was higher in women (37%) vs. men (31%) and it increased with age (8.4% before age 18 to 43% in age 85 and over) and with SES score. In contrast, 4.3% had uncontrolled HbA1c during the entire period, and 20.3% had at least one test result of HbA1c>9 during that period. More imbalanced patients were found to be younger (18-44), predominantly male (54.2% vs. 45.8%), and with lower SES score.

Conclusion: Only one third of diabetic patients maintain continuous glycemic control and at least 25% will have episodes of uncontrolled HbA1c. There is a strong need for better treatment interventions especially among the young and underprivileged.