Glycemic control in patients with type 2 diabetes mellitus in Spain

A Pérez; J J Mediavilla; I Miñambres; D González-Segura

doi:10.1016/j.rce.2014.05.028

Glycemic control in patients with type 2 diabetes mellitus in Spain

Rev Clin Esp (Barc). 2014 Nov;214(8):429-36. doi: 10.1016/j.rce.2014.05.028. Epub 2014 Jul 10.

[Article in English, Spanish]

Authors

A Pérez¹, J J Mediavilla², I Miñambres³, D González-Segura⁴

Affiliations

¹ Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) , Barcelona, España. Electronic address: aperez@santpau.cat.
² Centro de Salud Burgos Rural Sur, Burgos, España.
³ Servicio de Endocrinología y Nutrición, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España.
⁴ Departamento Médico Almirall S.A., Barcelona, España.

PMID: 25016415
DOI: 10.1016/j.rce.2014.05.028

Abstract

Objective: To evaluate the degree of glycemic control in patients with type 2 diabetes in Spain and identify factors associated with glycemic control.

Patients and methods: This was a cross-sectional, multicenter, epidemiological study that used consecutive sampling and was conducted in primary care practices in Spain. A total of 5591 patients with type 2 diabetes mellitus lasting more than 1 year and who were treated with hypoglycemic agents for more than 3 months were included in the study. At a single visit, HbA1c levels were measured (A1cNow+ system) and demographic and clinical variables related to diabetes and its treatment were recorded. During the visit, CV risk factors (CVRF), the presence of target-organ damage (TOD), the presence of hypoglycemia and body weight changes within the previous year were recorded.

Results: We analyzed data from 5382 patients (mean age 66.7 [10.8] years, mean duration of the diabetes 8.8 [6.3] years). TOD was present in 43.6% of the patients and 59.1% were taking 2 or more drugs. The patients' mean HbA1c was 7.1 (1.1)%, and 48.6% had HbA1c levels <7.0%. The patients with HbA1c levels ≥7.0% had longer-standing diabetes, a higher prevalence of TOD and CVRF, used more complex therapies, experienced more hypoglycemic episodes in the previous year and had more weight gain. In the multivariate analysis, the absence of insulin treatment, the absence of abdominal obesity and atherogenic dyslipidemia, a duration of the diabetes <10 years and an age >70 years were associated with improved glycemic control.

Conclusions: Patients with poorly controlled type 2 diabetes mellitus are highly prevalent in Spain. Factors associated with poorer glycemic control include the complexity of both the disease and the hypoglycemic therapy, a history of hypoglycemia and weight gain.

Keywords: Antidiabéticos orales; Atención primaria; Atherogenic dyslipidemia; Control glucémico; Diabetes tipo 2; Dislipemia aterogénica; Duración de la diabetes; Duration of diabetes; Glycemic control; Insulin therapy; Insulinoterapia; Oral antidiabetic agents; Primary Care; Type 2 diabetes.