Achievement of partial combined control of major diabetes targets in primary care correlates with development of chronic complications in T2DM patients--A real life data

Prim Care Diabetes. 2015 Dec;9(6):412-7. doi: 10.1016/j.pcd.2015.05.001. Epub 2015 Jun 15.

Abstract

Aims: Strict long term glucose, cholesterol and blood pressure control is advocated in type 2 Diabetes Mellitus (T2DM) patients. It is not known whether combined partial goals' achievement affects development of chronic complications.

Methods: We evaluated the relative ability or failure of 5369 T2DM ambulatory patients to achieve and maintain control of blood pressure, glycaemia and cholesterol for 3 consecutive years. Correlation between the extent of combined goal achievement, and development of chronic complications was determined.

Results: Only 9 patients (0.17%) fully achieved and none completely failed to achieve all strict goals. Therefore, patients were characterized as either partial achievers (PA) (n=699) or partial non achievers (PNA) (n=322). As compared to PA patients, PNA patients were significantly younger, single, and demonstrated a higher female and Arab ethnicity dominance. PNA patients had higher BMI, received more insulin treatment and consumed more hospital services. The incidence of microvascular complications during 3 years was significantly increased in PNA patients.

Conclusions: A negligible number of primary care patients completely and persistently achieve or fail to achieve combined control of major diabetes targets. Partial achievement of these targets correlates with specific patients' characteristics and incidence of chronic micro-vascular complications.

Keywords: Achievement; Diabetes goals; Primary care; Real life data.

MeSH terms

  • Age Factors
  • Arabs
  • Biomarkers / blood
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Blood Pressure
  • Chronic Disease
  • Diabetes Complications / blood
  • Diabetes Complications / diagnosis
  • Diabetes Complications / ethnology
  • Diabetes Complications / physiopathology
  • Diabetes Complications / prevention & control*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / therapy*
  • Glycated Hemoglobin / metabolism
  • Health Resources / statistics & numerical data
  • Hospitalization
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Incidence
  • Insulin / therapeutic use*
  • Israel / epidemiology
  • Lipids / blood
  • Patient Care Planning* / standards
  • Patient Compliance*
  • Prevalence
  • Primary Health Care* / standards
  • Risk Factors
  • Sex Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • Lipids
  • hemoglobin A1c protein, human