title: Metabolic control and treatment patterns in patients with type 1 diabetes in Castilla-La Mancha: the DIAbetes tipo 1 in Castilla La Mancha study.
abstract: OBJECTIVE
  To assess glycemic control, the degree of control of cardiovascular risk factors, and treatment schemes used in patients with type 1 diabetes mellitus (T1DM) in Castilla-La Mancha (Spain).
  
  
  METHODS
  A cross-sectional, multicenter study on adult patients with T1DM seen at outpatient endocrinology clinics for 12 months (from September 2009 to August 2010). Diabetes duration was > 5 years in all cases. Sociodemographic, clinical, anthropometric, and laboratory variables were collected, as well as treatment data. A multivariate logistic regression analysis was used to assess variables independently associated to good glycemic control.
  
  
  RESULTS
  A total of 1465 patients (48.5% women) with a mean age of 39.4±13.5 years and a mean diabetes duration of 19.4±10.6 years, were enrolled. Mean glycosylated hemoglobin (HbA1c) level was 7.8%, and 26% had HbA1c values ≤7%. Predictors of good glycemic control (HBA1c ≤7%) included intensive insulin treatment [odds ratio (OR): 2.56], non-smoking status (OR: 1.66), and a higher educational level (OR: 1.33). Fifteen percent of patients were obese, 35% had dyslipidemia, 23% were hypertensive, and 26% smoked. Four or more of the recommended control goals were achieved by 68% of patients, but more than 33% required additional drug treatment.
  
  
  CONCLUSIONS
  Glycemic control was inadequate in this cohort of T1DM patients. Promotion of healthy attitudes and intensification of insulin treatment may improve glycemic control. Prevalence of cardiovascular risk factors is high, although a great proportion of patients achieve good lipid and blood pressure control.
authors.affiliation: Servicio de Endocrinología, Complejo Hospitalario de Toledo, Toledo, España. jsastrem@sescam.jccm.es
authors.forename: Julia
authors.initials: J
authors.lastname: Sastre
authors.forename: Pedro José
authors.initials: PJ
authors.lastname: Pinés
authors.forename: Jesús
authors.initials: J
authors.lastname: Moreno
authors.forename: Miguel
authors.initials: M
authors.lastname: Aguirre
authors.forename: Benito
authors.initials: B
authors.lastname: Blanco
authors.forename: Dulce
authors.initials: D
authors.lastname: Calderón
authors.forename: Sandra
authors.initials: S
authors.lastname: Herranz
authors.forename: Carlos
authors.initials: C
authors.lastname: Roa
authors.forename: José
authors.initials: J
authors.lastname: Lopez
mesh_terms: D000328:Adult; D000886:Anthropometry; D003131:Combined Modality Therapy; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy / Q000188:drug therapy / Q000453:epidemiology* / Q000378:metabolism; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin