title: Achievement of partial combined control of major diabetes targets in primary care correlates with development of chronic complications in T2DM patients--A real life data.
abstract: OBJECTIVE
  Strict long term glucose, cholesterol and blood pressure control is advocated in type 2 Diabetes Mellitus (T2DM) patients. It is not known whether combined partial goals' achievement affects development of chronic complications.
  
  
  METHODS
  We evaluated the relative ability or failure of 5369 T2DM ambulatory patients to achieve and maintain control of blood pressure, glycaemia and cholesterol for 3 consecutive years. Correlation between the extent of combined goal achievement, and development of chronic complications was determined.
  
  
  RESULTS
  Only 9 patients (0.17%) fully achieved and none completely failed to achieve all strict goals. Therefore, patients were characterized as either partial achievers (PA) (n=699) or partial non achievers (PNA) (n=322). As compared to PA patients, PNA patients were significantly younger, single, and demonstrated a higher female and Arab ethnicity dominance. PNA patients had higher BMI, received more insulin treatment and consumed more hospital services. The incidence of microvascular complications during 3 years was significantly increased in PNA patients.
  
  
  CONCLUSIONS
  A negligible number of primary care patients completely and persistently achieve or fail to achieve combined control of major diabetes targets. Partial achievement of these targets correlates with specific patients' characteristics and incidence of chronic micro-vascular complications.
authors.affiliation: Division of Internal Medicine and Diabetes Service Assaf Harofeh Medical Center affiliated to Tel Aviv University, Zerifin, Israel. Electronic address: mrapoport@asaf.health.gov.il.
authors.forename: Micha
authors.initials: M
authors.lastname: Rapoport
authors.affiliation: The Sami Shamoon College of Engineering, Ashdod, Israel.
authors.forename: Nissim
authors.initials: N
authors.lastname: Harel
authors.affiliation: Department of Family Medicine Leumit Health Services affiliated to Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Ygal
authors.initials: Y
authors.lastname: Shasha
authors.affiliation: College of Management Academic Studies, Rishon-Lezion, Israel.
authors.forename: Refael
authors.initials: R
authors.lastname: Barkan
authors.affiliation: Department of Family Medicine Leumit Health Services affiliated to Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Eliezer
authors.initials: E
authors.lastname: Kitaee
authors.affiliation: Division of Internal Medicine and Diabetes Service Assaf Harofeh Medical Center affiliated to Tel Aviv University, Zerifin, Israel.
authors.forename: Andreas
authors.initials: A
authors.lastname: Buchs
authors.affiliation: Semmelweis University, Budapest, Hungary.
authors.forename: Shimon
authors.initials: S
authors.lastname: Izhakian
authors.affiliation: Bar-Ilan University, Ramat-Gan, Israel.
authors.forename: Einat
authors.initials: E
authors.lastname: Aviel-Gadot
mesh_terms: D000367:Age Factors; D018912:Arabs; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001794:Blood Pressure; D002908:Chronic Disease; D048909:Diabetes Complications / Q000097:blood / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006295:Health Resources / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D015994:Incidence; D007328:Insulin / Q000627:therapeutic use*; D007557:Israel / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D010347:Patient Care Planning / Q000592:standards; D010349:Patient Compliance; D015995:Prevalence; D011320:Primary Health Care / Q000592:standards; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008055:Lipids; C517652:hemoglobin A1c protein, human
keywords: Achievement; Diabetes goals; Primary care; Real life data