Meeting individualized glycemic targets in primary care patients with type 2 diabetes in Spain
Por:
Minambres, I, Mediavilla, JJ, Sarroca, J, Perez, A
Publicada:
17 feb 2016
Resumen:
Background: Information about the achievement of glycemic targets in patients with type 2 diabetes according to different individualization strategies is scarce. Our aim was to analyze the allocation of type 2 diabetic patients into individualized glycemic targets according to different strategies of individualization and to assess the degree of achievement of adequate control.
Methods: Cross-sectional analysis on 5382 type 2 diabetic patients in primary care setting in Spain between 2011 and 2012. Targets of HbA1c were assigned based on different strategies of individualization of glycemic targets: 1) the ADA/EASD consensus 2) The Spanish Diabetes Society (SED) consensus 3) a strategy that accounts for the risk of hypoglycemia (HYPO) considering the presence of a hypoglycemia during the last year and type of hypoglycemic treatment. Concordance between the different strategies was analyzed.
Results: A total of 15.9, 17.1 and 67 % applied to ADA/EASD recommendation of HbA1c target of < 6.5, < 7 and < 8 % (48, 53 and 64 mmol/mol), and 31.9 and 67.4 % applied to the SED glycemic target of < 6.5 and < 7.5 % (< 48 and 58 mmol/mol). Using the HYPO strategy, 53.5 % had a recommended HbA1c target < 7 % (53 mmol/mol). There is a 94 % concordance between the ADA/EASD and SED strategies, and a concordance of 41-42 % between these strategies and HYPO strategy. Using the three different strategies, the overall proportion of patients achieving glycemic targets was 56-68 %.
Conclusions: Individualization of glycemic targets increases the number of patients who are considered adequately controlled. The proposed HYPO strategy identifies a similar proportion of patients that achieve adequate glycemic control than ADA/EASD or SED strategies, but its concordance with these strategies in terms of patient classification is bad.
Filiaciones:
Minambres, I:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr Serv, C St Quinti 89, Barcelona 08026, Spain
Hosp Santa Creu & Sant Pau, Res Inst, Barcelona 08026, Spain
Mediavilla, JJ:
Ctr Salud Burgos Rural, Burgos, Spain
Sarroca, J:
Almirall SA, Barcelona, Spain
Perez, A:
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr Serv, C St Quinti 89, Barcelona 08026, Spain
Hosp Santa Creu & Sant Pau, Res Inst, Barcelona 08026, Spain
Univ Autonoma Barcelona, Dept Med, E-08193 Barcelona, Spain
Diabet & Metab Dis CIBER CIBERDEM, Barcelona, Spain
Gold, Green Published
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