The treat-to-target paradigm: a cross-sectional survey of current therapies and achieved metabolic control in 800 type 2 diabetic patients.
The aim of this cross-sectional study is to analyse the current treatment schemes as well as the quality of control (metabolic; blood pressure) in a cohort of 800 type 2 diabetic patients recruited in a University Center and not by generalist practionners, in scope with current international recommendations. Insulin therapy was administered, alone or combined with oral antihyperglycaemic drugs, to 48% of subjects. HbA1c was 7.7% (6.7-8.7 (median; percentiles 25-75)). Antidyslipidaemic drugs were used in 45% of individuals. However, only 27% of the cohort had LDL levels lower than 100 mg/dl while 58% of males and 48% of females attained HDL targets. Systolic and diastolic blood pressure levels were 144 +/- 21 and 81 +/- 12 mmHg (mean +/- SD), despite one or more antihypertensive agent(s) prescribed to 68% of subjects. In conclusion, in a Belgian adult type 2 diabetic population attending a tertiary centre for follow-up, overall metabolic and blood pressure controls remain unsatisfactory according to targets defined by international guidelines. This audit makes a multi-faceted intervention aimed at intensifying current therapies all the more necessary.
Buysschaert
M
M
Service d'Endocrinologie et Nutrition, Cliniques Universitaires St Luc, Université Catholique de Louvain, B-1200 Brussels, Belgium. buysschaert@diab.ucl.ac.be
Hermans
M P
MP
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007279:Injections, Subcutaneous; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008659:Metabolic Diseases / Q000517:prevention & control*; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin