Just 14 percent of people with diabetes hit all the recommended health targets during the first decade of the 21st century, according to the new report from the U.S. Centers for Disease Control and Prevention and the U.S. National Institutes of Health.Researchers found that between 1999 and 2010, the number of people with diabetes who achieved their blood sugar goals improved by about 8 percent. That same time period saw a nearly 12 percent improvement in the number of people meeting their blood pressure goals. And 21 percent more people lowered their LDL cholesterol (the bad type) to less than 100 milligrams per deciliter during the study time period. Tobacco use was one area where the numbers didn't move.

The current report, published in the April 25 issue of the New England Journal of Medicine, includes data from more than 100,000 adults who reported a diabetes diagnosis by a health care professional. The data was from two nationally representative studies, but neither study broke its information down by diabetes type. Between 33 percent and 49 percent of people with diabetes were not meeting their targets for blood sugar, blood pressure and cholesterol control, the report found. Dr. Graham McMahon, a diabetes specialist at Brigham and Women's Hospital in Boston, finds the figures disappointing. "I think these results show slower than anticipated progress in meeting diabetes goals," he said. McMahon thinks changes are needed in the way diabetes is managed and reimbursed."Clinicians should be given credits for improvements toward a goal," he explained. "You want to have a combination of factors that acknowledge the difficulty and complexity of engaging patients in self-care."The best way for diabetes care providers to promote patients' self-care is to partner with them, he said. This includes exploring and dismantling the obstacles the patient experiences, noted McMahon.

"Diabetes can be all-consuming for a patient. It changes the way you interact with family and friends, and in how you view yourself, whether you consider yourself well or not well," McMahon said. Type 2 diabetes "also affects feelings of self-worth and fault because the community often blames people for having this problem." McMahon said he'd like to see care move toward a more patient-centered environment that can help patients identify helpful strategies for improving their health. This could be accomplished with health care teams -- including nurse educators, primary care doctors, endocrinologists, podiatrists, ophthalmologists and nutritionists -- that would address the whole patient, said McMahon.