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.