Achievement of guideline targets for blood pressure, lipid, and glycaemic control in type 2 diabetes: A meta-analysis

Kamlesh Khunti, Antonio Ceriello, Xavier Cos, Christophe De Block

Research output: Contribution to journalReview articlepeer-review


We assessed global achievement of targets recommended by the American Diabetes Association (ADA), European Association for the Study of Diabetes (EASD), and National Institute of Health and Care Excellence (NICE) for type 2 diabetes. We searched Medline, Embase, and The Cochrane Library for observational studies reporting target attainment (2006 to 2017 inclusive) for HbA1c, blood pressure, or lipids (low density lipoprotein cholesterol [LDL-C], high density lipoprotein cholesterol [HDL-C], or triglycerides). Rates were pooled using a random-effects meta-analysis. Study quality and risk of small study of bias was assessed. From 2491 screened records, 24 studies were included reporting on 369,251 people from 20 countries. The pooled target achievement rates were; 42.8% (95% CI 38.1–47.5%) for glycaemic control, 29.0% (22.9–35.9%) for blood pressure, 49.2% (39.0–59.4%) for LDL-C, 58.2% (51.7–64.4%) for HDL-C, and 61.9% (55.2–68.2%) for triglyceride control. A higher proportion of people achieved HbA1c targets within Europe and North America than the rest of the world. A higher proportion of people achieved blood pressure targets in North America than Europe or the rest of the world. Meta regression showed no significant improvement in rates by year for any target. The achievement of evidence-based targets is markedly suboptimal globally and not improving.

Original languageEnglish
Pages (from-to)137-148
Number of pages12
JournalDiabetes Research and Clinical Practice
Publication statusPublished - Mar 1 2018


  • Blood glucose
  • Blood pressure
  • Cholesterol
  • Diabetes mellitus, type 2
  • Guideline adherence
  • Lipoproteins

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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