Inadequate glycaemic control and antidiabetic therapy among inpatients with type 2 diabetes in Guangdong Province of China.
BACKGROUND
Diabetes mellitus has become epidemic in recent years in China. We investigated the prevalence of hyperglycaemia and inadequate glycaemic control among type 2 diabetic inpatients from ten university teaching hospitals in Guangdong Province, China.


METHODS
Inadequate glycaemic control in diabetic patients was defined as HbA1c = 6.5%. Therapeutic regimens included no-intervention, lifestyle only, oral antiglycemic agents (OA), insulin plus OA (insulin + OA), or insulin only. Antidiabetic managements included monotherapy, double therapy, triple or quadruple therapy.


RESULTS
Among 493 diabetic inpatients with known history, 75% had HbA1c = 6.5%. Inadequate glucose control rates were more frequently seen in patients on insulin + OA regimen (97%) than on OA regimen (71%) (P < 0.001), and more frequent in patients on combination therapy (81% - 96%) than monotherapy (75%) (P < 0.05). Patients on insulin differed significantly from patients on OA by mean HbA1c, glycemic control rate, diabetes duration, microvascular complications, and BMI (P < 0.01).


CONCLUSIONS
This study showed that glycaemic control of type 2 diabetic patients deteriorated for patients who received insulin and initiation time of insulin was usually delayed. It is up to clinicians to move from the traditional stepwise therapy to a more active and early combination antidiabetic therapy to provide better glucose control.
Bi
Yan
Y
Department of Endocrinology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
Yan
Jin-hua
JH
Liao
Zhi-hong
ZH
Li
Yan-bing
YB
Zeng
Long-yi
LY
Tang
Kuan-xiao
KX
Xue
Yao-ming
YM
Yang
Hua-zhang
HZ
Li
Lu
L
Cai
De-hong
DH
Wu
Ge
G
Zhang
Fan
F
Lin
Shao-da
SD
Xiao
Zheng-hua
ZH
Zhu
Da-long
DL
Weng
Jian-ping
JP
D000368:Aged; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007297:Inpatients; D008297:Male; D008875:Middle Aged
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human