Indicator Details — Native Americans: Glycemic Control in Persons with Diabetes by CKDa
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  • SHS

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Footnotes:
a P<0.001 for all subgroup comparisons of CKD vs. no CKD.





Overall, about one-third of American Indians with diabetes achieved glycemic control
Those without CKD had much greater rates of glycemic control (~40-50%) than those with CKD (~15-25%)
Chart Explanation: Overall, about one-third of American Indians with diabetes achieved glycemic control. Those without CKD had much greater rates of glycemic control (~40-50%) than those with CKD (~15-25%). Among those with CKD, greater severity of CKD was associated with greater glycemic control.
The Strong Heart Study consisted of several components and three study exams (baseline, 1989-1992; second exam, 1993-1995; and third exam, 1998-1999), followed by morbidity and mortality surveillance of 4,500 tribal participants. Strong Heart enrolled men and women aged 45-74 at baseline from 13 American Indian tribes/communities in Arizona, Oklahoma, and the Dakotas. A total of 1,832 Strong Heart participants with diabetes at baseline had baseline information on both kidney function (eGFR) and albuminuria (albumin:creatinine ratio) and information on hemoglobin A1c at exam ?. Glycemic control was defined by hemoglobin A1c  ≤ 7%.  CKD stages were defined by ACR > 30 mg/g and eGFR in ml/min/1.73 m2 by the 4-parameter MDRD Study equation.
FieldData
Description of MeasurePrevalence of glycemic control
Data SourceStrong Heart Study
Type of Data SourcePrivate
Data SetSHS
Health Care System DataNo
Regional or National?National
Demographic GroupAmerican Indians aged 45-74 from 13 tribes/communities 
NumeratorNumber of participants with diabetes who had glycemic control
DenominatorAll participants with diabetes
Definition of CKDNo CKD, eGFR >90 ml/min/1.73 m2 & albumin:creatinine ratio <30 mg/g
Stage 1, eGFR >90 ml/min/1.73 m2 & albumin:creatinine ratio >30 mg/g
Stage 2, eGFR 60-89 ml/min/1.73 m2 & albumin:creatinine ratio >30 mg/g
Stages 3-5, eGFR <60 ml/min/1.73 m
Glomerular filtration rateCalculated by MDRD-4 Study equation
ProteinuriaSpot urine albumin:creatinine ratio
Primary Data Source IndicatorPercentage of participants who had glycemic control (hemoglobin A1C<7%)
Primary Indicator Method of MeasurementLaboratory
Frequency of Measurement (Primary)Once
U.S. Region Covered by Primary VariableArizona, Oklahoma, and the Dakotas
Period Currently Available1993–1995
Pending DataPossible continued passive follow-up only
Additional Data Items of InterestAge, gender, diabetes, hypertension
Limitations of IndicatorPossible misclassification based on single measures
Analytical ConsiderationsAnalysis performed by SHS investigators; denominators for each study exam and indicator must be defined properly
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd