[Relationship between the degree of glycemic control and diabetes characteristics and hyperglycemia treatment in type 2 diabetes. DIABES Study]

Abstract

Background and objective: To evaluate the relationship between the degree of glycemic control and the features of the disease and glucose-lowering treatment in patients with type 2 diabetes mellitus in Spain.

Patients and methods: Cross-sectional epidemiological study in Spain with consecutive sampling. We recorded demographic and clinical variables of patients who were followed up in the center for >12 months.

Results: We analyzed data from 6,801 patients enrolled by 734 specialist and 965 primary care physicians: 97.8% received pharmacological treatment (30.3% monotherapy, 51,4% dual therapy, 16.1% triple therapy and 26.6% insulin). HbA(1c) was 7.3 (1.2) % and 40.4% of patients had HbA(1c)<7.0%. This proportion varied (P<.0001) according to the duration of diabetes (51.8% with <5 years, 39.6% with 5-10 years, 35.1% with 10-15 years and 31 4%>15 years) and the type of treatment (52.9% monotherapy, 35.6% dual therapy, 28.0% triple therapy and 25.2% insulin). In the multivariate analysis, insulin therapy (odds ratio [OR] 0.329; IC(95%) 0,267-0,405) and the presence of components of metabolic syndrome (hypertriglyceridemia and/or low HDL and/or abdominal obesity (OR 0.728; IC(95%) 0,595-0,890) were associated with poor glycemic control.

Conclusions: We observed an impairment of glycemic control with the progression of the disease and the complexity of the process and treatment, which in part may be related to the inadequate treatment selection and intensification.