title: Achievement of therapeutic targets in Mexican patients with diabetes mellitus.
abstract: OBJECTIVE
  Complications of diabetes comprise the leading cause of death in Mexico. We aimed to describe the characteristics of management and achievement of therapeutic targets in Mexican patients with diabetes mellitus.
  
  
  METHODS
  We analyzed data from 2642 Mexican patients with type 1 (T1D, n=203, 7.7%) and type 2 diabetes (T2D, n=2439, 92.3%) included in the third wave of the International Diabetes Management Practices Study.
  
  
  RESULTS
  Of T2D patients, 63% were on oral glucose-lowering drugs (OGLD) exclusively (mostly metformin), 11% on insulin, 22% on OGLD plus insulin, and 4% on diet and exercise exclusively. T2D patients on insulin were more likely to be trained on diabetes, but they were older, had worse control, longer disease duration and more chronic complications than patients on OGLD only. Glycated hemoglobin (HbA1c) <7% was achieved by 21% and 37% of T1D and T2D patients, respectively. Only 5% of T1D and 3% of T2D attained the composite target of HbA1c <7%, blood pressure <130/80 mmHg and low-density lipoprotein cholesterol <100 mg/dl. T1D patients had less macrovascular but more microvascular complications, compared with T2D patients. Late complications increased with disease duration, so that about 80% of patients after 20 years of diagnosis have at least one late complication. Reaching the target HbA1c <7% was associated with a reduced number of microvascular but not with less macrovascular complications.
  
  
  CONCLUSIONS
  A great proportion of these Mexican patients with diabetes did not reach therapeutic targets. Insulin was used mostly in complicated cases with advanced disease.
authors.affiliation: Department of Endocrinology, Hospital Universitario Dr. José Eleuterio González, Monterrey, NL, Mexico. fjlavallegzz@hotmail.com
authors.forename: Fernando J
authors.initials: FJ
authors.lastname: Lavalle-González
authors.forename: Erwin
authors.initials: E
authors.lastname: Chiquete
authors.forename: Julieta
authors.initials: J
authors.lastname: de la Luz
authors.forename: Ana
authors.initials: A
authors.lastname: Ochoa-Guzmán
authors.forename: Laura V
authors.initials: LV
authors.lastname: Sánchez-Orozco
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Godínez-Gutiérrez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D008078:Cholesterol, LDL / Q000097:blood; D003131:Combined Modality Therapy; D015897:Comorbidity; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D003927:Diet, Diabetic; D004359:Drug Therapy, Combination; D005081:Exercise Therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin