Meeting individualized glycemic targets in primary care patients with type 2 diabetes in Spain
Miñambres, Inka (Institut d'Investigació Biomèdica Sant Pau)
Mediavilla, Javier J. (Centro de Salud Burgos Rural)
Sarroca, Jordi (Almirall, S.A.)
Pérez Pérez, Antonio (Universitat Autònoma de Barcelona. Departament de Medicina)
Universitat Autònoma de Barcelona

Data:	2016
Resum:	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. 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. 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 %. 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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Type 2 diabetes ; Glycemic control ; Glycemic targets ; Individualization
Publicat a:	BMC Endocrine Disorders, Vol. 16 (february 2016) , ISSN 1472-6823

DOI: 10.1186/s12902-016-0090-1
PMID: 26887662

7 p, 423.5 KB

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