Achievement of ABC Goals in Type 2 Diabetes in Real-life.

Q3 Medicine The Journal of the Association of Physicians of India Pub Date : 2024-11-01 DOI:10.59556/japi.72.0730

Hemraj Balchand Chandalia, Jayshri Dilip Jain, Sonal Hemraj Chandalia

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Abstract

Introduction: This real-life observational study from a diabetes centre in Western India reports the status of A1C (glycated hemoglobin), blood pressure, and cholesterol levels (ABC goals) currently achieved in type 2 diabetic patients. Research design and methods: A cohort of 497 patients of type 2 diabetes first seen at the Diabetes Endocrine Nutrition Management and Research Centre from the years 2014 to 2017 were followed for a median [interquartile range (IQR)] duration of 21.5 (7, 33) months. A minimum of two follow-up clinical evaluations and investigations were analyzed. Results: Hemoglobin A1C (HbA1c) dropped significantly in the whole cohort (HbA1c, Percent: initial 9.0 ± 1.98, follow-up 7.66 ± 1.73; p < 0.0001). Increasing duration of diabetes showed a significantly poorer achievement of HbA1c targets on follow-up (HbA1c 0-5 years vs 5.1-10 years and >10 years, p < 0.001). Pretreatment HbA1c of <6, 6.1-7, 7.1-7.5, 7.6-8, 8.1-9, and >9% was seen in 2, 15, 11, 8, 20, and 44%, respectively. The corresponding HbA1c values on follow-up were 5, 30, 14, 11, 17, and 23%, respectively. Sodium-glucose transport protein 2 inhibitor (SGLT2i) group was in poorer control (HbA1c 8.20 ± 1.71) at follow-up than non-SGLT2i group (HbA1c 7.55 ± 1.72), p < 0.001) probably due to significantly greater use of sulphonylurea as background therapy in SGLT2i group (SGLT2i group 72.2%, non-SGLT2i group 58.7%, p < 0.02). Initial ABC targets were at goal for HbA1c, high blood pressure, and low-density lipoprotein (LDL) cholesterol in 17, 40, and 33% of patients, respectively. On follow-up, percent of patients at goal were HbA1c 35%, hypertension 95.77%, and LDL cholesterol 75.85%. Conclusion: The study brings out the difficulties in achieving HbA1c goals as compared to blood pressure and LDL cholesterol goals. Additionally, it brings out the efficacy of sulphonylureas as a treatment modality. Longer duration of diabetes resulted in lower achievement of glycemic targets.

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在现实生活中实现 2 型糖尿病患者的 ABC 目标。

简介：这项来自印度西部一家糖尿病中心的真实观察研究报告了 2 型糖尿病患者目前达到 A1C（糖化血红蛋白）、血压和胆固醇水平（ABC 目标）的情况。研究设计和方法：对 2014 年至 2017 年期间在糖尿病内分泌营养管理和研究中心首次就诊的 497 名 2 型糖尿病患者进行了队列随访，中位数[四分位数间距 (IQR)]随访时间为 21.5 (7, 33) 个月。对至少两次随访临床评估和检查进行了分析。结果整个队列中的血红蛋白 A1C (HbA1c) 显著下降（HbA1c，百分比：初始 9.0 ± 1.98，随访 7.66 ± 1.73；P < 0.0001）。糖尿病病程越长，随访的 HbA1c 目标实现情况越差（HbA1c 0-5 年 vs 5.1-10 年和 >10 年，p < 0.001）。治疗前 HbA1c 为 9% 的患者分别占 2%、15%、11%、8%、20% 和 44%。随访时相应的 HbA1c 值分别为 5%、30%、14%、11%、17% 和 23%。钠-葡萄糖转运蛋白 2 抑制剂（SGLT2i）组在随访时的控制情况（HbA1c 8.20 ± 1.71）差于非 SGLT2i 组（HbA1c 7.55 ± 1.72，P < 0.001），这可能是因为 SGLT2i 组使用磺脲类药物作为背景治疗的比例明显更高（SGLT2i 组为 72.2%，非 SGLT2i 组为 58.7%，P < 0.02）。分别有 17%、40% 和 33% 的患者 HbA1c、高血压和低密度脂蛋白胆固醇的初始 ABC 指标达到目标。随访结果显示，达到目标的患者比例分别为 HbA1c 35%、高血压 95.77% 和低密度脂蛋白胆固醇 75.85%。结论与血压和低密度脂蛋白胆固醇目标相比，该研究揭示了实现 HbA1c 目标的困难。此外，研究还揭示了磺脲类药物作为一种治疗方式的有效性。糖尿病病程越长，血糖目标的实现率越低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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