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We aimed to characterize secular trends in diabetes prevalence, control of glucose and associated comorbidities, and medication use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective analysis of National Health and Nutrition Examination Series data from 2001 to 2023. We focused on three outcomes: (1) prevalence of diabetes defined by known diagnosis, hemoglobin A1c\u2009\u2265\u20096.5%, or fasting glucose\u2009\u2265\u2009126\u00a0mg\/dL, and among individuals with diabetes (2) control of glucose levels, low-density lipoprotein, and blood pressure and (3) medication therapy. Predictors were cycle (year) and demographics, specifically age, sex, race\/ethnicity, educational level, and household income.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 27,437 participants of whom 3467 had diagnosed diabetes and an additional 1602 had undiagnosed diabetes. Diabetes prevalence increased from 10.0% in 2001\u20132002 to 15.1% in 2021\u20132023 and was higher in men versus women, and Hispanic\/Latino or non-Hispanic Black vs. non-Hispanic White participants. Glycemic control declined over time, from 61.5 to 44.9% having hemoglobin A1c\u2009&lt;\u20097% in 2001\u20132002 vs. 2021\u20132023; control was lower in younger participants and those with lower educational attainment. Lipid control improved over time but remained poor: 73.1% had low-density lipoprotein\u2009\u2265\u200970\u00a0mg\/dL in 2017\u20132020, and only half of these individuals were taking a statin. There were no significant changes over time in blood pressure control, with 44\u201356% having blood pressure\u2009\u2265\u2009130\/80\u00a0mmHg. Other than lower lipid control in women, we did not observe differences in control of lipids or blood pressure, or in medication treatment, based on sex and race\/ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Diabetes has increased in prevalence from 2001 to 2023 and management of hyperglycemia and associated risk factors remains inadequate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00592-025-02572-6","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T06:30:04Z","timestamp":1753857004000},"page":"2159-2170","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Diabetes prevalence and management patterns in US adults, 2001\u20132023"],"prefix":"10.1007","volume":"62","author":[{"given":"Miaojin","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael H.","family":"Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee Hui","family":"Yeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karn","family":"Wijarnpreecha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisa","family":"Likhitsup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donghee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0157-6066","authenticated-orcid":false,"given":"Vincent L.","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"2572_CR1","unstructured":"National Diabetes Statistics Report (2024) https:\/\/www.cdc.gov\/diabetes\/php\/data-research\/index.html. 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