Global guideline recommended target achievements in glycaemic, blood pressure, and lipid control in type 2 diabetes: An updated meta-analysis of 1,618,972 participants.

AIMS: Despite advancements in diabetes management, adherence to HbA1c, blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) targets remains suboptimal. This review presents an updated meta-analysis of the achievement of these guideline targets globally in individuals with type 2 diabetes. This study included studies from 2017 to 2025, supplementing our prior meta-analysis covering 2006-2017.

METHODS

Observational studies assessing adherence to HbA1c, BP, and LDL-C targets and a combined target attainment were included. Random-effects meta-analysis was used to estimate pooled proportions, and meta-regression assessed the impact of study characteristics on target achievement.

RESULTS

A total of 63 studies from 2006 to 2025, encompassing 1,618,972 patients, were included. Overall, 44% (95% CI: 41-48%) of individuals achieved HbA1c targets, 41% (95% CI: 34-47%) achieved BP targets, and 47% (95% CI: 42-51%) achieved LDL-C targets. Only 12% (95% CI: 7-16%) of individuals met all three targets simultaneously. Meta-regression analysis revealed no significant improvement in HbA1c target attainment from 1997 to 2023 in Europe and North America.

CONCLUSIONS

Despite advances in pharmacotherapy, the achievement of targets for risk factor control in type 2 diabetes remains alarmingly low, with little progress over time. This review highlights the urgent need to address barriers in achieving guideline targets.