French medical practice in type 2 diabetes: The need for better control of cardiovascular risk factors

Marant, C; Romon, I.; Fosse, S.; Weill, Alain; Simon, Dominique; Eschwège, É.; Varroud-Vial, Michel; Fagot-Campagna, A.

doi:10.1016/j.diabet.2007.09.003

Cited by 31 publications

(15 citation statements)

References 9 publications

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“…This population of type 2 diabetic patients with ADR related to their medications presents characteristics comparable to those observed in other studies about French type 2 diabetes [29-31]: for example, we found that 11% of the patients suffered from cardiac insufficiency, which is very similar to the 12% observed in the ENTRED national survey [30]. Moreover, the patterns of exposure to drugs in this population are in agreement with the guidelines for TZD use at the time of the study (in particular, TZDs are contraindicated with insulin and for patients with NYHA class I to IV).…”

Section: Discussionsupporting

confidence: 82%

Drug safety of rosiglitazone and pioglitazone in France: a study using the French PharmacoVigilance database

et al. 2011

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BackgroundThiazolidinediones (TZDs), rosiglitazone (RGZ) and pioglitazone (PGZ) are widely used as hypoglycemic drugs in patients with type 2 diabetes mellitus. The aim of our study was to investigate the profile of adverse drug reactions (ADRs) related to TZDs and to investigate potential risk factors of these ADRs.MethodsType 2 diabetic patients were identified from the French Database of PharmacoVigilance (FPVD) between 2002 and 2006. We investigated ADR related to TZD, focusing on 4 ADR: edema, heart failure, myocardial infarction and hepatitis corresponding to specific WHO-ART terms.ResultsAmong a total of 99,284 adult patients in the FPVD, 2295 reports concerned type 2 diabetic patients (2.3% of the whole database), with 161 (7%) exposed to TZDs. The frequency of edema and cardiac failure was significantly higher with TZDs than in other patients (18% and 7.4% versus 0.8% and 0.1% respectively, p < 0.001) whereas the frequency of hepatitis was similar (5.9% versus 4%, NS). A multiple logistic regression model taking into account potential confounding factors (age, gender, drug exposure and co-morbidities) found that TZD exposure remained associated with heart failure and edema, but not with hepatitis or myocardial infarction.ConclusionsThiazolidinediones exposure is associated with an increased risk of edema and heart failure in patients with type 2 diabetes even when recommendations for use are respected. In contrast, the risk of hepatic reactions and myocardial infarction with this class of drugs seems to be similar to other hypoglycemic agents.

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Section: Discussionsupporting

confidence: 82%

Drug safety of rosiglitazone and pioglitazone in France: a study using the French PharmacoVigilance database

et al. 2011

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“…Cette proportion est de même ordre de grandeur que celle obtenue par Vezi et Naido (2005) chez les Noires en Afrique du Sud, mais supérieure à celle obtenue par Klisiewics et Raal (2009) dans toute la population de ce même pays. L'augmentation du cholestérol LDL et des triglycérides suggère une faible utilisation de thérapeutiques visant à corriger cette dyslipidémie, c'est-à-dire l'association de mesures hygiéno-diététiques et des statines (Marant et al, 2008). En effet, dans ce travail, seuls 2,1% des sujets étaient sous hypocholestérolémiants.…”

Section: Resultatsunclassified

“…De même, le profil le plus athérogène, caractérisé par une augmentation du cholestérol LDL et une diminution du cholestérol HDL, n'est retrouvé dans notre étude que chez 31,8%. Cette faible proportion va dans le sens d'un contrôle plus régulier du bilan lipidique, comme le proposent Marant et al (2008), car la répartition obtenue dans ce travail est susceptible de modifications au fil du temps, et surtout en fonction de l'équilibre glycémique.…”

Section: Resultatsunclassified

Profil lipidique, cinétique d’apparition des diènes conjugués et activité paraoxonase-1 chez le diabétique de type 2 à Libreville au Gabon

Abessolo¹,

Bekale²,

Jose³

et al. 2012

Int. J. Bio. Chem. Sci

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RESUMEL'objectif de ce travail était d'identifier la fréquence des dyslipidémies du diabétique de type 2 afin d'apprécier l'efficacité de leur prise en charge. Pour cela, une étude prospective et ponctuelle, a été menée du 1 er janvier au 30 octobre 2010. Elle a concerné les patients diabétiques de type 2, avec ou sans complications macro et microvasculaires. Un bilan lipidique a été réalisé chez ces patients à jeun depuis 12 heures, associé à la détermination du temps de latence d'apparition des diènes conjugués et l'activité paraoxonase-1 (PON1). Il a été démontré que le LDL était élevé chez 65,2%, alors que le HDL était réduit chez 63,6% des diabétiques. Le profil le plus athérogène, caractérisé par une augmentation du LDL et une diminution du HDL intéressait 31,8% des sujets. La dyslipidémie classiquement associée au diabète de type 2, n'était retrouvée que chez 8,3% des patients. Ces anomalies quantitatives étaient accompagnées de modifications qualitatives des lipides, à type de diminution du temps de latence d'apparition des diènes conjugués ou de l'activité PON1 avec la chronicité de la maladie. Ces résultats suggèrent l'amélioration des mesures de prise en charge des dyslipidémies chez les diabétiques de type 2, non seulement avec les statines, mais également les dérivés de l'acide nicotinique et même des antioxydants comme la vitamine E.

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“…The definition of treated diabetic patients that was considered in this study finds its roots in the methodology of the ENTRED study [12-14], a validated transversal epidemiological study defining treated diabetic patients as having at least three A10 reimbursements in the year, to avoid false positive patients (prescription and diagnosis errors). Since the DIABECOLUX study was longitudinal, the above definition was softened to take into account the continuity of the treatment.…”

Section: Methodsmentioning

confidence: 99%

An algorithm to identify patients with treated type 2 diabetes using medico-administrative data

Renard

Bocquet²,

Vidal-Trécan

et al. 2011

BMC Med Inform Decis Mak

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BackgroundNational authorities have to follow the evolution of diabetes to implement public health policies. An algorithm was developed to identify patients with treated type 2 diabetes and estimate its annual prevalence in Luxembourg using health insurance claims when no diagnosis code is available.MethodsThe DIABECOLUX algorithm was based on patients' age as well as type and number of hypoglycemic agents reimbursed between 1995 and 2006. Algorithm validation was performed using the results of a national study based on medical data. Sensitivity, specificity and predictive values were estimated.ResultsThe sensitivity of the DIABECOLUX algorithm was found superior to 98.2%. Between 2000 and 2006, 22,178 patients were treated for diabetes in Luxembourg, among whom 21,068 for type 2 diabetes (95%). The prevalence was estimated at 3.79% in 2006 and followed an increasing linear trend during the period. In 2005, the prevalence was low for young age classes and increased rapidly from 40 to 70 for male and 80 for female, reaching a peak of, respectively 17.0% and 14.3% before decreasing.ConclusionsThe DIABECOLUX algorithm is relevant to identify treated type 2 diabetes patients. It is reproducible and should be transferable to every country using medico-administrative databases not including diagnosis codes. Although undiagnosed patients and others with lifestyle recommendations only were not considered in this study, this algorithm is a cheap and easy-to-use tool to inform health authorities. Further studies will use this tool with the aim of improving the quality of health care dedicated to diabetic patients in Luxembourg.

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French medical practice in type 2 diabetes: The need for better control of cardiovascular risk factors

Cited by 31 publications

References 9 publications

Drug safety of rosiglitazone and pioglitazone in France: a study using the French PharmacoVigilance database

Drug safety of rosiglitazone and pioglitazone in France: a study using the French PharmacoVigilance database

Profil lipidique, cinétique d’apparition des diènes conjugués et activité paraoxonase-1 chez le diabétique de type 2 à Libreville au Gabon

An algorithm to identify patients with treated type 2 diabetes using medico-administrative data

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