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Clinical course of a cohort with type 2 diabetes mellitus after endocrine assessment. A 26-week study.

Authors
  • Herranz-Antolín, Sandra1
  • Álvarez-de Frutos, Visitación2
  • Torralba, Miguel3
  • 1 Sección de Endocrinología y Nutrición, Hospital Universitario de Guadalajara, Guadalajara, España. Electronic address: [email protected]
  • 2 Sección de Endocrinología y Nutrición, Hospital Universitario de Guadalajara, Guadalajara, España.
  • 3 Unidad de Investigación, Universidad de Alcalá de Henares, Servicio de Medicina Interna, Hospital Universitario de Guadalajara, Guadalajara, España.
Type
Published Article
Journal
Endocrinologia, diabetes y nutricion
Publication Date
Apr 01, 2018
Volume
65
Issue
4
Pages
220–228
Identifiers
DOI: 10.1016/j.endinu.2017.11.006
PMID: 29358046
Source
Medline
Keywords
Language
Spanish
License
Unknown

Abstract

To assess the degree of metabolic control and hypoglycemic treatments in a cohort of patients with type 2 diabetes mellitus (T2DM) after evaluation in an endocrinology clinic. A prospective cohort study on 465 patients with T2DM who were not being monitored at an endocrinology clinic. Blood glucose control data and treatments received were recorded at an initial visit and after 26 weeks of follow-up. Baseline glycosylated hemoglobin (HbA1c) level was 8.3±1.8%, as compared to 6.6±0.9% after 26 weeks of follow-up (P<.0001). The proportion of patients with HbA1c levels <7% increased from 33.1% to 71.3% (P<.0001). In 59.9% of patients, a decrease ≥0.8% in HbA1c was seen. In the multivariate analysis, variables predicting for an improvement in the degree of metabolic control were older age (OR 1.038; 95%CI 1-1.07; P=.041), higher baseline HbA1c values (OR 5.51; 95%CI 3.4-9; P<.0001), T2DM duration <5 years (OR 4.63; 95%CI 1.6-13.3; P=.005), and change in hypoglycemic treatment (OR 2.77, 95%CI 1.1-6.9; P=.03). Hypoglycemic therapy was changed in 75.1% of study patients with T2DM. After 26 weeks of follow-up, decreases were seen in both the proportion of patients who receiveding no treatment (from 7% to 0.3%, P<.0001) and the proportions of patients on oral antidiabetic therapy (60.9% vs 55.5%, P=.003) and insulin (10.5% vs 6.2%, P=.021). However, the proportion of patients receiving insulin combined with oral antidiabetic drugs increased from 21.1% to 38% (P<.0001). An improved metabolic control was seen in this cohort of patients with T2DM after their evaluation in an endocrinology clinic. However, HbA1c levels <7% were not achieved in 28.7% of patients, which shows the difficulty to achieve adequate control in clinical practice. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

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