Glycaemic control and implementation of the ADA/EASD-2006 consensus algorithm in type 2 diabetes mellitus patients in primary care in Spain.

Abstract

BACKGROUND:

In 2006, the American Diabetes Association and the European Association for the Study of Diabetes established a consensus algorithm (ADA/EASD-2006) for the adjustment of drug therapy for type 2 diabetes mellitus (T2DM).

AIMS:

To study glycaemic control in T2DM patients and the implementation of the ADA/EASD-2006 recommendations in primary care centres in Spain.

METHODS:

Prospective observational study in 1194 patients with T2DM conducted in 250 primary care centres in Spain. Patients were assessed at study inclusion (V0) and at 3 (V1) and 6 months (V2) post baseline. Information was collected at the level of DM control, HbA(1c) < 7% (HbC) and implementation of the ADA/EASD-2006 guidelines.

RESULTS:

Type 2 diabetes mellitus patients (53% women; mean age 64.9 years) had a mean (SD) HbA(1c) 7.8 (1.4)% and HbC 25.2% at baseline, 95% of them were receiving oral antihyperglycaemic agents (AAs) only. At V1, HbA(1c) was 7.3 (1.1)% and HbC was 38.1%; 65.0% of patients were receiving oral AAs, 5.6% insulin and 27.9% oral AAs plus insulin. At V2, HbA(1c) was 7.1 (0.9)% and HbC was 48.0%; 57.1% of patients were receiving oral AAs, 5.0% insulin and 36.9% oral AAs plus insulin. The ADA/EASD-2006 algorithm was adhered to in 33% patients up to study month 3, vs. 17.2% throughout the entire 6-month period.

CONCLUSION:

In patients with T2DM seen in primary care, the HbA1c target was met in 48.0% after adjusting their AAs. However, this is not reflected in greater implementation of the ADA/EASD-2006 guidelines, which are adhered to in only 17%.

• Authors: F Alvarez-Guisasola, Guiada Study Group
• Journal: International journal of clinical practice (Int J Clin Pract) Vol. 68 Issue 1 Pg. 28-39 (Jan 2014) ISSN: 1742-1241 [Electronic] India
• PMID: 24341300 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 John Wiley & Sons Ltd.

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• Hypoglycemic Agents

Topics

• Algorithms
• Blood Glucose (metabolism)
• Consensus
• Diabetes Mellitus, Type 2 (blood, prevention & control)
• Drug Therapy, Combination
• Fasting (blood)
• Female
• Glycated Hemoglobin (metabolism)
• Guideline Adherence
• Humans
• Hypoglycemic Agents (therapeutic use)
• Male
• Middle Aged
• Practice Guidelines as Topic
• Primary Health Care (methods)
• Prospective Studies
• Spain
• Treatment Outcome