Diabetes treatment patterns and goal achievement in primary diabetes care (DiaRegis) - study protocol and patient characteristics at baseline

Abstract

BackgroundPatients with type 2 diabetes are at an increased risk for disease and treatment related complications after the initial approach of oral mono/dual antidiabetic therapy has failed. Data from clinical practice with respect to this patient group are however scarce. Therefore we set up a registry in primary care documenting the course and outcomes of this patient group.MethodsDiabetes Treatment Patterns and Goal Achievement in Primary Diabetes Care (DiaRegis) is a prospective, observational, German, multicenter registry including patients with type-2 diabetes in which oral mono/dual antidiabetic therapy has failed. Data were recorded at baseline and will be prospectively documented during visits at 6 ± 1, 12 ± 2 and 24 ± 2 months. The primary objective is to estimate the proportion of patients with at least 1 episode of severe hypoglycemia within one year.Results313 primary care offices included 4,048 patients between June 2009 and March 2010 of which 3,810 patients fulfilled the in- and exclusion criteria. 46.7% of patients were female; patients had a median diabetes duration of 5.5 years and most were obese with respect to BMI or waist circumference. HbA1c at baseline was 7.4%, fasting plasma glucose 142 mg/dl and postprandial glucose 185 mg/dl. Co-morbidity in this patient population was substantial with 17.9% having coronary artery disease, 14.4% peripheral neuropathy, 9.9% heart failure and 6.0% peripheral arterial disease. 68.6% of patients received oral monotherapy, 31.4% dual oral combination therapy. The most frequent antidiabetic agent used as monotherapy was metformin (79.0%) followed by sulfonylureas (14.8%).ConclusionsDiaRegis is a large, prospective registry in primary diabetes care to document the course and outcomes of patients with type-2 diabetes in which the initial approach of oral mono/dual antidiabetic therapy has failed. The two year follow-up will allow for a prospective evaluation of these patients during multiple adjustments of therapy.

Oral antidiabetic treatment in type-2 diabetes in the elderly: balancing the need for glucose control and the risk of hypoglycemia

“…Patients with mild hypoglycemia were defined as being with or without specific symptoms but manageable without help. These were usually detected by self-measurements of blood glucose (<2.22 mmol/l; 40 mg/dl in any case; 2.22-2.78 mmol/l or 50 mg/dl in case of symptoms) [12,14]. Patients with moderate hypoglycemia experienced symptoms of hypoglycemia and required assistance from a second person (e.g.…”

“…The present analysis, based on data of the DiaRegis (Diabetes Treatment Patterns and Goal Achievement in primary diabetes care) registry [12-15], aims at determining patient characteristics and clinical variables in the elderly that are associated with an increased risk of hypoglycemia, taking into account specific age related issues such as co-morbid disease and underlying medical treatment.…”

Geoprocessamento em Saúde Pública: fundamentos e aplicações

“…Considerando que a maioria dos estudos e o próprio Programa Nacional de Controle da Tuberculose priorizam intervenções para adultos, um estudo desenvolvido em um estado brasileiro endêmico enfocou a distribuição da tuberculose infantil para estimativa de risco e identificou áreas de transmissão recente, que podem estar relacionadas com contatos intradomiciliares 48 . O uso do geoprocessamento estende-se, ainda, à investigação da distribuição dos casos ou de fatores relacionados de outras doenças crônicas, como diabetes e hipertensão arterial 49,50 . Essa ferramenta pode colaborar para o mapeamento digital das áreas de abrangência das Unidades de Saúde e da assistência realizada pelos profissionais de saúde.…”

Incidence, characteristics and impact of hypoglycaemia in patients receiving intensified treatment for inadequately controlled type 2 diabetes mellitus

“…Details regarding the study design and baseline patient characteristics have been previously published. 9 All patients enrolled in the DiaRegis registry provided written informed consent and were followed for a total of 24 months. DiaRegis was endorsed by the 'Diabetics with Heart Failure Foundation', a subsidiary of the 'German Diabetes Foundation'.…”