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BMC Endocr Disord. 2016 Feb 17;16:10. doi: 10.1186/s12902-016-0090-1.

Meeting individualized glycemic targets in primary care patients with type 2 diabetes in Spain.

Author information

1
Department of Endocrinology and Nutrition Services, Hospital de la Santa Creu i Sant Pau, C/ Sant Quintí, 89, 08026, Barcelona, Spain.
2
Research Institute, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
3
Centro de Salud Burgos Rural, Burgos, Spain.
4
Almirall S.A., Barcelona, Spain.
5
Department of Endocrinology and Nutrition Services, Hospital de la Santa Creu i Sant Pau, C/ Sant Quintí, 89, 08026, Barcelona, Spain. aperez@santpau.cat.
6
Research Institute, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. aperez@santpau.cat.
7
Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. aperez@santpau.cat.
8
Diabetes and Metabolic Diseases CIBER (CIBERDEM), Barcelona, Spain. aperez@santpau.cat.

Abstract

BACKGROUND:

Information about the achievement of glycemic targets in patients with type 2 diabetes according to different individualization strategies is scarce. Our aim was to analyze the allocation of type 2 diabetic patients into individualized glycemic targets according to different strategies of individualization and to assess the degree of achievement of adequate control.

METHODS:

Cross-sectional analysis on 5382 type 2 diabetic patients in primary care setting in Spain between 2011 and 2012. Targets of HbA1c were assigned based on different strategies of individualization of glycemic targets: 1) the ADA/EASD consensus 2) The Spanish Diabetes Society (SED) consensus 3) a strategy that accounts for the risk of hypoglycemia (HYPO) considering the presence of a hypoglycemia during the last year and type of hypoglycemic treatment. Concordance between the different strategies was analyzed.

RESULTS:

A total of 15.9, 17.1 and 67 % applied to ADA/EASD recommendation of HbA1c target of <6.5, < 7 and <8 % (48, 53 and 64 mmol/mol), and 31.9 and 67.4 % applied to the SED glycemic target of <6.5 and <7.5 % (<48 and 58 mmol/mol). Using the HYPO strategy, 53.5 % had a recommended HbA1c target <7 % (53 mmol/mol). There is a 94 % concordance between the ADA/EASD and SED strategies, and a concordance of 41-42 % between these strategies and HYPO strategy. Using the three different strategies, the overall proportion of patients achieving glycemic targets was 56-68 %.

CONCLUSIONS:

Individualization of glycemic targets increases the number of patients who are considered adequately controlled. The proposed HYPO strategy identifies a similar proportion of patients that achieve adequate glycemic control than ADA/EASD or SED strategies, but its concordance with these strategies in terms of patient classification is bad.

PMID:
26887662
PMCID:
PMC4756540
DOI:
10.1186/s12902-016-0090-1
[Indexed for MEDLINE]
Free PMC Article

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