Quest Diagnostics Health Trends(TM) Diabetes Report Is Based on 14.3
Million Test Results From 2001 - 2005 From the Nation's Largest Database of Clinical Lab Results
LYNDHURST, N.J., May 3 /PRNewswire/ -- People with diabetes who visit
health professionals are doing a better job of managing their disease,
according to results from the Quest Diagnostics Health Trends (TM) Diabetes
Report. However, the Report also found that nearly half of all test results
in 2005 were still above the target goal for diabetes control set by the
American Diabetes Association (ADA).
The Health Trends Diabetes Report is based on 14.3 million hemoglobin
A1c test results performed from 2001 through 2005 by Quest Diagnostics
laboratories in the United States on patients whose physicians classified
them as having diabetes through the use of specific diagnostic (ICD-9)
codes. The proportion of test results deemed to represent good diabetes
control increased from 36 percent in early 2001 to a high of 56 percent in
late 2005, according to the Quest Diagnostics Report.
Quest Diagnostics Health Trends reports identify and track disease and
wellness benchmarks. They are made available as a public service to inform
patients, health professionals, and policy-makers about the current status
of the nation's health. The Diabetes Report is the second in the series of
Health Trends reports, following the Heart Health Report on LDL cholesterol
levels, which Quest Diagnostics issued in October 2005.
The test for hemoglobin A1c (HbA1c) is a key indicator of diabetes
control. It measures the amount of sugar attached to hemoglobin, the
primary protein in red blood cells and indicates a patient's average blood
sugar level over the previous two to three months. The ADA recommends that
people with diabetes maintain their hemoglobin A1c levels below 7 percent
of the total hemoglobin in red blood cells. The Health Trends Diabetes
Report showed that the average hemoglobin A1c test result decreased from
7.8 percent of total hemoglobin in January 2001 to 7.2 percent in December
2005. This represents a drop of 8 percent.
"What makes these data so interesting is that they suggest that over
time, glucose control is getting better," said Nathaniel G. Clark, M.D.,
M.S., R.D., National Vice President, Clinical Affairs, American Diabetes
Association. "This is in direct contrast to the National Health and
Nutrition Examination Survey (NHANES) data which suggests that diabetes
control in the United States population declined through the period of the
late 1990s. NHANES provides the context that makes the Quest Diagnostics
data from the last five years so interesting."
"These results are a great contribution to our understanding of the
state of diabetes care and outcomes in the United States," said Francine R.
Kaufman, M.D., professor of pediatrics at the Keck School of Medicine,
University of Southern California, and past president of the ADA. "They
indicate that diabetes care has improved over the last five years with
glucose-lowering agents, a push to multidisciplinary care, stricter
criteria for diabetes diagnosis and public and professional awareness
campaigns about the importance of early diagnosis and treating to target."
"Possible explanations are greater awareness of both the use of and
goals for HbA1c, frequency of HbA1c testing and better use of available
medications," said Dr. Clark, of the ADA.
The number of test results included in the Health Trends Diabetes
Report is more than one hundred times that of other published reports on
diabetes health. "This is a huge data set with enormous statistical power
that helps us understand the state of control of diabetes in the United
States," said David E. Goldstein, M.D., Professor Emeritus, University of
Missouri Health Sciences Center, the first director of the national
standardization program for HbA1c and principal investigator for the
landmark Diabetes Control and Complications Trial. "This is valuable
information for healthcare professionals, policy makers and payers."
"The Quest Diagnostics database not only is larger than any of the
existing research studies but also provides more current data," said Josef
Coresh, M.D., Ph.D., Professor of Epidemiology, Biostatistics & Medicine,
Johns Hopkins University.
Most of the improvement in HbA1c results was observed within the first
three years encompassed by the report. The reason for the slow-down in
improvement in 2004 and 2005 is not known, but it could be attributed, at
least in part, to the difficulty in getting closer to the goal as HbA1c
results decrease. "As one approaches an HbA1c level of 7 percent it becomes
harder and harder to make improvements," Dr. Clark said. "Moving from 10
percent to 9 percent is far easier than moving from 8 percent to 7 percent
or lower."
On average, patients were tested 1.9 times per calendar year. This
average testing frequency was the same in each of the five years. The ADA
recommends that patients with stable diabetes control have their HbA1c
measured twice a year. The vast majority of these tests were ordered by
physicians in an office setting.
Another significant finding from the Quest Diagnostics Health Trends
Diabetes Report is seasonal variation in HbA1c, with peak levels in winter
months (December through February). This seasonal variation in HbA1c has
been described. Climate and the decreased activity levels and higher food
intake associated with the winter holidays have been mentioned as possible
causes.
Diabetes is a growing health concern in the United States. More than 14
million Americans are currently diagnosed with diabetes and an additional 6
million may have diabetes and not know it, according to the U.S. Centers
for Disease Control and Prevention. Diabetes is a chronic condition in
which the body does not produce or properly use insulin to convert sugar
into energy. If poorly managed or undiagnosed, diabetes may lead to serious
complications including heart attack, stroke, blindness, amputation and
kidney failure.
"There is a serious need for clinical baselines to determine how well
we are succeeding at controlling this disease, and the Health Trends
Diabetes Reports takes an important step in that direction by offering the
first national set of clinical benchmarks," said Gary Puckrein, Ph.D.,
Executive Director of the National Minority Health Month Foundation in
Washington, D.C.
The data used for Quest Diagnostics Health Trends reports consist of
results of tests performed by Quest Diagnostics laboratories across the
United States. Quest Diagnostics' database of aggregated results of patient
testing data is the largest of its kind in the country.
"As the world of healthcare is looking to evidence-based medicine to
drive better outcomes, we are proud to be able to use our large clinical
database to provide quantitative insights into patient health," said Surya
N. Mohapatra, Ph.D., Chairman and Chief Executive Officer, Quest
Diagnostics. "Our Health Trends Diabetes Report demonstrates the power of
our unique database to show important changes in the way that healthcare
providers are helping people control their diabetes."
Study Methodology and Limitations
The Quest Diagnostics Health Trends Diabetes Report encompasses a
sample of 14.3 million test results for people with diabetes who visited a
health care provider and used a Quest Diagnostics laboratory during the
years 2001 - 2005. It does not represent a random sample of the general
population. It does not reflect the health of people who did not visit
health professionals for diabetes or for whom HbA1c testing was not
ordered. The Report excluded an additional 18.7 million hemoglobin A1c
tests performed by Quest Diagnostics during the time period covered by the
Report because the physician did not include the most commonly used
diagnostic codes for diabetes (ICD-9 codes starting with 250) in the test
order.
This study does not follow a cohort, but rather analyzes all test
results for patients classified as having diabetes for whom any HbA1c test
was performed over the five-year period, regardless of when their first
test occurred during this period. Quest Diagnostics does not have access to
clinical data that could help to explain the data trends, such as treatment
prescribed.
As recommended by the ADA, the HbA1c testing method used by Quest
Diagnostics throughout the five-year period is certified by the NGSP, the
agency that ensures standardization of HbA1c testing worldwide, making
results directly comparable to values from the Diabetes Control and
Complications Trial.
Observed trends were consistent across geographic regions, and when
analyzed by age and gender, suggested that there were no significant
population or demographic changes to account for these trends.
About Quest Diagnostics
Quest Diagnostics is the leading provider of diagnostic testing,
information and services that patients and doctors need to make better
healthcare decisions. The company offers the broadest access to diagnostic
testing services through its national network of laboratories and patient
service centers, and provides interpretive consultation through its
extensive medical and scientific staff. Quest Diagnostics is a pioneer in
developing innovative new diagnostic tests and advanced healthcare
information technology solutions that help improve patient care. Additional
company information is available at: http://www.questdiagnostics.com.
The statements in this press release that are not historical facts or
information may be forward-looking statements. These forward-looking
statements involve risks and uncertainties that could cause actual results
and outcomes to be materially different. Certain of these risks and
uncertainties may include, but are not limited to, competitive environment,
changes in government regulations, changing relationships with customers,
payers, suppliers and strategic partners and other factors described in the
Quest Diagnostics Incorporated 2005 Form 10-K and subsequent SEC filings.
Contacts:
Gary Samuels (Media)
1-201-393-5700
Laure Park (Investors)
1-201-393-5030
SOURCE Quest Diagnostics
Web Site: http://www.questdiagnostics.com