Achievement of Cardiometabolic Goals among Diabetic Patients in Spain. A Nationwide Population-Based Study

Navarro-Vidal, Beatriz; Banegas, José R.; León‐Muñoz, Luz M.; Rodríguez‐Artalejo, Fernando; Graciani, Auxiliadora

doi:10.1371/journal.pone.0061549

Cited by 34 publications

(14 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the current study, there was no clear evidence that diagnosed T2DM patients were significantly better at maintaining healthy dietary habits and lifestyle than undiagnosed subjects. This finding is in accordance with a previous finding that diabetes awareness was not associated with improved achievement of healthy cardiometabolic biomarker levels [ 46 ]. Nevertheless, the possibility that people with undiagnosed diabetes may be at greater risk for diabetic complications, including obesity, albuminuria, hypertension, and dyslipidemia [ 47 ], cannot be eliminated, as diagnosed T2DM subjects may have more opportunities to have regular medical check-ups and participate in health promotion programs [ 48 49 ].…”

Section: Discussionsupporting

confidence: 93%

Trends in adherence to dietary recommendations among Korean type 2 diabetes mellitus patients

Park

2015

Nutr Res Pract

View full text Add to dashboard Cite

BACKGROUND/OBJECTIVESThe current study examined trends in adherence to dietary recommendations and compared the levels of adherence between diagnosed and undiagnosed subjects with type 2 diabetes mellitus (T2DM) in Korea over the past 14 years.SUBJECTS/METHODSData were collected from the 1998-2012 Korea National Health and Nutrition Examination Surveys (KNHANES). Diagnosed diabetes was defined as giving a positive response to questions about awareness of the disease, a physician's diagnosis of diabetes, or medical treatment for diabetes, whereas undiagnosed diabetes was defined as having a fasting glucose level ≥ 126 mg/dl. Assessment of adherence level was based on 6 components of dietary guidelines, considering meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol. The participants received 1 point if they met the criteria for each of the 6 components, and the total possible score ranged from 0 to 6 points. Multivariate generalized linear regression was performed, taking into account the complex survey design.RESULTSAmong all diabetic patients aged 30 years or older, the proportion of diagnosed diabetes increased dramatically, from 40.9% in 1998 to 75.9% in 2012 (P for trend < 0.001). The overall adherence levels to dietary recommendations were low and did not significantly differ between diagnosed and undiagnosed subjects with T2DM for all survey years. Several improvements were observed, including increased adherence to maintaining sufficient vegetable/seaweed consumption (increased from 0.12 to 0.16 points) and limiting sodium intake (increased from 0.12-0.13 points to 0.19-0.24 points; P for trend < 0.001), while adherence to maintaining moderate alcohol consumption decreased.CONCLUSIONSAnalysis of data collected by the KNHANES indicates that Korean T2DM patients have poor adherence to dietary recommendations and maintenance of a healthy lifestyle, regardless of disease awareness. This finding suggests that development of practical, evidence-based guidelines is necessary and that provision and expansion of educational programs for T2DM patients is critical after diagnosis.

show abstract

Section: Discussionsupporting

confidence: 93%

Trends in adherence to dietary recommendations among Korean type 2 diabetes mellitus patients

Park

2015

Nutr Res Pract

View full text Add to dashboard Cite

show abstract

“…Despite significant improvements in diabetes care observed over the past decade, the current level of care in Germany as in other countries such as the USA, 21 34–37 Canada, 40 and Spain 41 falls short of guideline recommendations. Similar to these studies, 21 40 41 the results of the present analysis based on data from German national health surveys show that about two-thirds of persons with type 2 diabetes reached the target of HbA1c <7.0% (53 mmol/mol), and only 11.4% of patients with diabetes achieved stringent targets in HbA1c, TC, BP, and smoking combined. There was little change in the prevalence of current smokers among adults with diabetes in our study similar to US diabetes population studies.…”

Section: Discussionmentioning

confidence: 98%

Changes in diabetes care indicators: findings from German National Health Interview and Examination Surveys 1997–1999 and 2008–2011

Heidemann

Rosario

et al. 2015

BMJ Open Diab Res Care

View full text Add to dashboard Cite

ObjectivesTo investigate changes in type 2 diabetes care indicators over time in Germany.MethodsAdults aged 45–79 years with type 2 diabetes were identified from two national health examination surveys conducted in 1997–1999 (GNHIES98, n=333) and in 2008–2011 (DEGS1, n=526). We examined diabetes care indicators including treatment and preventive targets (glycemic control, blood pressure (BP), total cholesterol (TC), smoking, weight reduction, sports activity), self-management and care process measures (glucose self-monitoring, holding a diabetes passport, annual foot and eye examination; statin use), and the presence of diabetes-specific complications (diabetic nephropathy, retinopathy, neuropathy, diabetic foot, amputations) and comorbid cardiovascular disease (CVD) or chronic kidney disease (CKD). We calculated proportions of persons meeting these care indicators by survey and examined unadjusted and adjusted changes between surveys.ResultsSignificant improvement (GNHIES98 vs DEGS1) over time was observed for glycated hemoglobin (HbA1c) <7.0% (53 mmol/mol) (32.4% vs 65.4%), BP <130/80 mm Hg (32.0% vs 47.2%), TC <190 mg/dL (13.5% vs 41.9%), statin use (11.7% vs 35.9%), eye (51.1% vs 78.4%) and foot (48.0% vs 61.4%) examination within the past 12 months, diabetes-specific complications (29.7% vs 21.8%), and CVD (44.5% vs 37.1%). Blood glucose self-monitoring significantly increased (37.4% vs 62.8%), while holding a diabetes passport did not change. Current smoking did not change and obesity rose, although sports activity significantly increased over time. Proportions of adults achieving combination goals of HbA1c, BP, TC, and smoking cessation were low in both surveys in spite of significant improvement.ConclusionsIn Germany, the quality of diabetes care improved over time. There is much room for improvement, in particular regarding preventive goals and diabetes self-management.

show abstract

“…In a cross-sectional survey done in 2008-2010 among 12,077 Spanish individuals, about 71% had HbA1c <7%, 22% had blood pressure <130/80 mmHg, and 36% reached the LDL-cholesterol goal of <100 mg/dl. Though the scenario appears better than other countries, the authors concluded that even in a country with universal healthcare coverage, glycemic control among aware diabetic individuals was poor and suggested a need for improvement in both clinical guidelines' implementation and patients' adherence [10]. Studies from India also show poor glycemic control amongst subjects with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Glycemic control amongst diabetic subjects on insulin therapy: Still off target!

Shetty¹,

Ramachandrappa²

2019

Int J Med Res Rev

View full text Add to dashboard Cite

Introduction:Prevalence of diabetes is increasing worldwide. Good glycemic control is essential for prevention of complications of diabetes. Despite of availability of multiple medications, it is difficult to achieve good glycemic control. Insulin therapy is considered to be the best option available for attaining glycemic control. But, whether insulin therapy has achieved it is an important question to be addressed. Objective: To assess the glycemic control in subjects with diabetes on insulin therapy. Materials and Methods: A cross-sectional study was done at Karnataka Institute of Endocrinology and research, Bangalore, in 448 diabetic patients who were on insulin therapy as a part of their diabetic therapy. Data collected was analyzed using SPSS 22 version software. Results: Majority of the subjects were men (61.38%) and in the age group of > 60 years (44.9%). Many of the subjects on insulin therapy had duration of diabetes > 5 years, with 36.4% having duration of 10-20 years, while another 36% had duration of 5 -10 years. Premixed insulin (81.47%) was the most commonly used insulin regimen. 82.6% of the subjects were on conventional insulin and only 13.2% were on insulin analogues. Insulin syringe was the most commonly used delivery device, with 64.7% of subjects using it, while insulin pen was used by 33.5% subjects. Despite of insulin therapy, the glycemic control was poor and 81.4% had HbA1c >8%. Only 5.7% of the subjects had HbA1c <7%. 94.9% of the subjects reported that they were regular with their insulin therapy. Only 20.1% adjusted the insulin dose by self. Conclusions: The present study has found that despite being on insulin therapy, large percentage of subjects was unable to achieve good glycemic control.

show abstract

Achievement of Cardiometabolic Goals among Diabetic Patients in Spain. A Nationwide Population-Based Study

Cited by 34 publications

References 23 publications

Trends in adherence to dietary recommendations among Korean type 2 diabetes mellitus patients

Trends in adherence to dietary recommendations among Korean type 2 diabetes mellitus patients

Changes in diabetes care indicators: findings from German National Health Interview and Examination Surveys 1997–1999 and 2008–2011

Glycemic control amongst diabetic subjects on insulin therapy: Still off target!

Contact Info

Product

Resources

About