Diabetes
Historical trends in glycated hemoglobin in people living with type-2 diabetes in Mexico between 2012 and 2024 Francisco Canto-Osorio* Francisco Canto-Osorio Canto-Osorio Canto-Osorio Canto-Osorio Canto-Osorio Canto-Osorio Canto-Osorio Canto-Osorio Canto-Osorio National Institute of Public Health, Mexico
Introduction:
Despite ongoing public health interventions aimed at improving diabetes control in Mexico, the temporal evolution of glycemic control distributions among individuals with type 2 diabetes remains poorly characterized. This is important, as higher glycated hemoglobin (HbA1c) levels are linked to T2D complications and death. Using repeated nationally representative surveys, we characterized the trends of HbA1c among adults with controlled and uncontrolled T2D in Mexico from 2012 to 2024.
Methods: We used data from the National Health and Nutrition Survey (ENSANUT) for 2012, 2016, 2018, and the continuous survey from 2021 through 2024. We included adults aged ≥20 years living with T2D with valid blood samples and an HbA1c determination (n=21,592). For each survey, we examined the HbA1c distribution to assess shifts in the population-level HbA1c over time. We estimated the proportion of individuals under control (HbA1c <7.0%), and across progressively higher HbA1c categories (>7-8, >8-9, >9-11, >11). All estimates were standardized by the age distribution of people living with T2D in 2021-2024.
Results: From 2012 to 2018, the HbA1c distribution shifted towards lower HbA1c levels, suggesting overall improvements in glycemic control in people living with T2D. However, these improvements plateau in 2021–2024 (Figure 1a). The proportion of individuals achieving glycemic control increased from 26.5% in 2012 to 42.1% in 2018, but decreased to 35.4% in 2021–2024. Similarly, the prevalence of poor glycemic control at the highest HbA1c levels (9–11% and >11%) decreased between 2012 and 2018 but showed a slight increase in 2021–2024 (Figure 1b).
Conclusion: Glycemic control in Mexico is low and seems to have stalled in recent years, with evidence of worsening both in the proportion achieving glycemic targets and in the prevalence of severe hyperglycemia.
