[Compliance and optimisation of oral antidiabetic therapy. A longitudinal study].
OBJECTIVE
To evaluate the impact of optimization of treatment and improvement in observance awareness in patients with type 2 diabetes on compliance with oral antidiabetic drug therapy and long-term glycemic control. Method Evaluation of compliance with oral antidiabetic therapy and of HbA1c levels in a cohort of 4 802 patients with type 2 diabetes followed by their general practitioner, before and after 6 Months on optimized treatment: reduction in percentage of combination treatments from 69.5 to 56.8%, and increase in percentage of once-daily dosing regimen from 12 to 58.4%.


RESULTS
Optimization of treatment led to an increase in the percentage of patients achieving optimal compliance with oral antidiabetic drug therapy from 44 to 69.5% after 6 Months (p<0.001). Metabolic control also improved, as evidenced by a decrease in HbA1c levels observed both in the whole cohort (7.5+/-1.6% to 6.9+/-1.2%; p<0.0005), as well as in individual therapeutic subgroups of patients (having switched from multiple-daily dosing to once-daily-dosing schedules and from gliclazide 80 to gliclazide 30 MR once-daily formulation).


CONCLUSIONS
These findings suggest that optimization of oral antidiabetic therapy favoring the use of oral antidiabetic agents with once-daily dosing administration modalities may improve metabolic control in patients with type 2 diabetes.
Guillausseau
Pierre-Jean
PJ
Service de médecine B, hôpital Lariboisière, 2 rue Ambroise Paré, 75010 Paris Université Paris 7. jean-guillausseau@lrb.ap-hop-paris.fr
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003625:Data Collection; D003627:Data Interpretation, Statistical; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D005907:Gliclazide / Q000008:administration & dosage*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires; D013997:Time Factors
D001786:Blood Glucose; D005907:Gliclazide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents