Treatment of hyperglycaemia in type 2 diabetic patients in a primary care population register in Catalonia (Spain)

Mata-Cases, Manel; Mauricio, Daniel; Vinagre, Irene; Morros, Rosa; Hermosilla, Eduardo; Fina, Francesc; Rosell, Magdalena; Castell, Carmelo Dueñas; Franch‐Nadal, Josep; Bolíbar, Bonaventura

doi:10.1016/j.pcd.2012.10.056

Cited by 4 publications

(6 citation statements)

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“…This relationship between BMI strata and age is consistent with previously published data [23, 24] . Previous epidemiological studies in Spain, performed over the entire age spectrum of the general adult population, had found a direct association between BMI and age up to the fifth or sixth decade [25, 26].…”

Section: Discussionsupporting

confidence: 93%

“…Glycemic control was related to T2D duration in the current analysis, but this duration was similar in patients aged >75 years and in those aged 65–75 years. A more recent analysis of the Catalan data similarly revealed deterioration in glycemic control with increasing duration of T2D [ 24 ]. The major randomized clinical trials that provided evidence supporting intensive glycemic control (ACCORD [ 37 ], ADVANCE [ 38 ], and VADT [ 39 ]) also confirmed the importance of adequate, comprehensive treatment of cardiovascular risk factors to prevent macrovascular complications [ 10 ], and this aspect of patient management was insufficiently addressed in the patients of this pooled analysis.…”

Section: Discussionmentioning

confidence: 99%

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Relationships between obesity, glycemic control, and cardiovascular risk factors: a pooled analysis of cross-sectional data from Spanish patients with type 2 diabetes in the preinsulin stage

Vázquez

Rodríguez

Salvador

et al. 2014

BMC Cardiovasc Disord

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BackgroundObesity is associated with the onset of type 2 diabetes mellitus (T2D), but reports conflict regarding the association between obesity and macrovascular complications. In this study, we investigated associations between cardiovascular risk factors and body mass index (BMI) and glycemic control in non–insulin-treated patients with T2D.MethodsAuthors gathered cross-sectional data from five observational studies performed in Spain. Generalized logit models were used to analyze the relationship between cardiovascular risk factors (independent variables) and 5 BMI strata (<25 kg/m2, 25 to <30 kg/m2, 30 to <35 kg/m2, 35 to <40 kg/m2, ≥40 kg/m2) and 5 glycated hemoglobin (HbA1c) strata (≤6.5%, >6.5–7%, >7–8%, >8–9%, >9%) (dependent outcomes).ResultsIn total, data from 6442 patients were analyzed. Patients generally had mean values of investigated cardiovascular risk factors outside recommended thresholds. Younger patients had higher BMI, triglyceride levels and HbA1c than their older counterparts. Diastolic blood pressure, systolic blood pressure and triglyceride levels were directly correlated with BMI strata, whereas an inverse correlation was observed between BMI strata and high-density lipoprotein cholesterol (HDL-C) levels, patient age, and duration of T2D. Increased duration of T2D and total cholesterol levels, and decreased HDL-C levels were associated with a higher HbA1c category. BMI and HbA1c levels were not associated with each other.ConclusionsAs insulin-naïve patients with T2D became more obese, cardiovascular risk factors became more pronounced. Higher BMI was associated with younger age and shorter duration of T2D, consistent with the notion that obesity at an early age may be key to the current T2D epidemic. Glycemic control was independent of BMI but associated with abnormal lipid levels. Further efforts should be done to improve modifiable cardiovascular risk factors.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2261-14-153) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Relationships between obesity, glycemic control, and cardiovascular risk factors: a pooled analysis of cross-sectional data from Spanish patients with type 2 diabetes in the preinsulin stage

Vázquez

Rodríguez

Salvador

et al. 2014

BMC Cardiovasc Disord

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“…The European countries surveyed by Overbeek [22] reported sulfonylureas to be the second most commonly prescribed drug class across all countries however this study also reported a decrease in the use of sulfonylureas in the Europe (2008)(2009)(2010)(2011)(2012). In Spain (2009) [24] and Germany (2004 to 2010) [25] sulfonylureas were reported to be prescribed for about 17% and 12% of patients, respectively. Filion et al [26] reported a decrease in the number of patients receiving sulfonylurea prescriptions in the period 2000 to 2006.…”

Section: Trends In the Use Of Antidiabetic Medicines Sulfonylureasmentioning

confidence: 99%

“…A similar trend was described in Germany (2004 to 2010) [25] where 20 % of patients were prescribed metformin. Mata-cases (2014) [24] reported that 41% of the patients in Spain were prescribed metformin. Metformin was also reported to reach its peak as a first-line treatment in the UK in 2013 (91.0 %) [31] and another study [30] conducted over the same time-period showed similar results (90.7%).…”

Section: Metforminmentioning

confidence: 99%

Trends in global prescribing of antidiabetic medicines in primary care: A systematic review of literature between 2000–2018

Ramzan

Timmins

Hasan

et al. 2019

Primary Care Diabetes

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Clinicians makes informed treatment choices based on available evidence and treatment guidelines. The aim of this review is to examine changes in the use of diabetes medicines prescribed to treat type 2 diabetes mellitus (T2DM) in the primary care setting. The use of antidiabetic medicines has evolved between 2000 and 2018. The number of drug classes available for treatment has increased steadily over these years, impacting on prescribing patterns. It was not possible to determine how clinicians make choices about the medicines they prescribe for T2DM, or what influences those choices.

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“…HbA1c level < 7.0% as the primary glycaemic control target for diabetics is suggested by the American Diabetes Association (ADA) guidelines [11]. The percentage of patients who reach this objective seems to be notably lower (24%) in the case of less-controlled T2DM patients [12,13]. Increasing HbA1c levels were correlated with macro vascular and microvascular disease whereas decrease in HbA1c level decreases the prevalence of long term complications [14,15].…”

Section: Introductionmentioning

confidence: 99%

Glycemic control of Obese Patients with Type 2 Diabetes Mellitus

2018

IJDMD

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Background and Objective: The incidence of type 2 diabetes mellitus is growing. Some national studies have measured glycemic control in people with type 2 diabetes mellitus. The objective of this study was to measure the glycemic control in obese patients with type 2 diabetes mellitus. Methods: A retrospective study of patients with type 2 diabetes mellitus and body mass index >30.0 kg/m2 at the primary health care department and diabetic Centre. Results: A total of 809 participants with T2DM and BMI ≥30.0 kg/m2 were studied. The mean age of the study population was 53.1 ± 11.6 years with 54.5 ± 12.5 years for males and 52.5 ± 11.1 years for females, p=0.02. Moreover, the prevalence of males was 248(30.7%) and the prevalence of females was 561(69.3%) with males to females ratio was 1.00: 2.26, p<0.0001. Mean BMI was 35.3 ± 4.7 kg/m2 and mean HbA1c was 9.3 ± 2.3. In the study population, 458(56.6%) were obese Grade I, 242 (29.9%) were obese Grade II while 109 (13.5%) were morbidly obese (obese Grade III), p=0.001 was significant compared to non diabetic cases. Obese Grade I have significantly a higher HbA1c compared to obese Grade II and III. Higher HbA1c was significantly correlated with lower BMI, r= - 0.1, p=0.002. Moreover, increased BMI were strongly linked to females; 60.7%, 77.7% and 87.2% respectively and were found to be statistically significant (P < 0.0001), as indicated in table. Summarizes the relationship between mean HbA1c according to obesity categories stratified by gender figure 1. There is a clear no significant separation of the HbA1c line between the males and females where mean HbA1c for males were higher in all obesity categories. There were slopes up of the mean Hba1c with slope down line for mean BMI as age groups advanced with similar pattern for males and females. A better HbA1c goal in BMI (30-34) group and that was true for females. The frequency of Hba1c goal was increasing with increasing age groups. Conclusion: These data indicate that many obese patients with T2DM have poor glycemic control where they will be at high risk of diabetic complications. More national studies are needed to assess glycemic control among obese diabetic patients in Saudi Arabia.

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Treatment of hyperglycaemia in type 2 diabetic patients in a primary care population register in Catalonia (Spain)

Cited by 4 publications

References 0 publications

Relationships between obesity, glycemic control, and cardiovascular risk factors: a pooled analysis of cross-sectional data from Spanish patients with type 2 diabetes in the preinsulin stage

Relationships between obesity, glycemic control, and cardiovascular risk factors: a pooled analysis of cross-sectional data from Spanish patients with type 2 diabetes in the preinsulin stage

Trends in global prescribing of antidiabetic medicines in primary care: A systematic review of literature between 2000–2018

Glycemic control of Obese Patients with Type 2 Diabetes Mellitus

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