Representativeness of Participants in the ACCORD Trial Compared to Middle-aged and Older Adults Living with Diabetes in the United States

Authors

Ryo Ikesu, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
Yingyan Wu, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
Scott C. Zimmerman, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Kosuke Inoue, Department of Social Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Peter Buto, Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Melinda C. Power, Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC., USA.
Catherine A. Schaefer, Division of Research, Kaiser Permanente, Northern California, Oakland, CA, USA.
M Maria Glymour, Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Elizabeth Rose Mayeda, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.

Document Type

Journal Article

Publication Date

5-20-2024

Journal

Epidemiology (Cambridge, Mass.)

DOI

10.1097/EDE.0000000000001746

Abstract

BACKGROUND: We evaluated whether participants in the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial represent U.S. adults aged ≥40 with diabetes. METHODS: Using the nationally representative 2017-2020 pre-pandemic National Health and Nutrition Examination Survey (NHANES) data, we made operational definitions of ACCORD eligibility criteria. We calculated the percentage of individuals aged ≥40 with diabetes and HbA1c ≥6.0% or ≥7.5% who met operational ACCORD eligibility criteria. RESULTS: Applying survey sampling weights to 715 NHANES participants aged ≥40 with diabetes and HbA1c ≥6.0% (representing 29,717,406 individuals), 12% (95% confidence interval [CI]: 8-18%) met the operational ACCORD eligibility criteria. Restricting to HbA1c ≥7.5%, 39% (95% CI: 28-51%) of respondents met the ACCORD criteria. CONCLUSIONS: ACCORD represented a minority of U.S. middle-aged and older adults with diabetes. Given the differential risk profile between ACCORD participants and the general population with diabetes, extrapolating the trial findings may not be appropriate.

APA Citation

Ikesu, Ryo; Wu, Yingyan; Zimmerman, Scott C.; Inoue, Kosuke; Buto, Peter; Power, Melinda C.; Schaefer, Catherine A.; Glymour, M Maria; and Mayeda, Elizabeth Rose, "Representativeness of Participants in the ACCORD Trial Compared to Middle-aged and Older Adults Living with Diabetes in the United States" (2024). GW Authored Works. Paper 4909.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4909

Department

Epidemiology