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Am J Manag Care. 2006 Aug;12(8):435-40.

Polypharmacy with oral antidiabetic agents: an indicator of poor glycemic control.

Author information

  • 1Meyers Primary Care Institute, 630 Plantation Street, Worcester, MA 01605, USA.

Abstract

OBJECTIVE:

To evaluate antidiabetic drug treatment patterns and glycemic control among patients diagnosed with type 2 diabetes mellitus.

STUDY DESIGN:

Retrospective study using the automated databases of a 200 000-member HMO.

METHODS:

The study population consisted of patients > or =18 years of age with documented type 2 diabetes mellitus from January 1, 2002, through December 31, 2002. We determined the proportion of patients who had optimal glycemic control (glycosylated hemoglobin <7%) during the 6 months after the initial documentation of diabetes during calendar year 2002 (index date).

RESULTS:

Of the 4282 patients who met the inclusion criteria, 1050 (25%) received 1 oral agent, 486 (11%) received 2 oral agents, 56 (1%) received > or =3 oral agents, 84 (2%) received insulin and an oral agent, and 107 (2%) received insulin exclusively within 90 days after the index date. Among the 1075 patients receiving antidiabetic drug therapy who had a laboratory test result documented, 414 (39%) had optimal glycemic control. Optimal control was most frequent among patients receiving 1 oral agent (47%) and least frequent among patients receiving > or =3 oral agents (13%) (P <.01). Patients with a prior history of suboptimal glycemic control were less likely to have optimal glycemic control.

CONCLUSIONS:

Multiple oral antidiabetic agents may serve as a marker for more severe, uncontrolled diabetes. The vast majority of patients treated with multiple oral antidiabetic agents had suboptimal glycemic control, suggesting a need for intensified efforts to treat this particular group of patients to recommended goal levels.

PMID:
16886886
[PubMed - indexed for MEDLINE]
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