Prediction of treatment response in patients with newly diagnosed type 2 diabetes: the Skaraborg diabetes register.
OBJECTIVE
Type 2 diabetes is associated with cardiovascular complications. It is largely unknown which patients have poor treatment response and high complication risk; biomarkers are studied for this purpose. The aim of the study was to investigate the association between clinical factors such as HbA1c, level of biomarkers (C-peptide, copeptin) at diagnosis and changes in HbA1c, blood pressure or body mass index (BMI) after five years.


METHODS
Clinical data and blood samples from 460 newly diagnosed type 2 diabetes patients from the Skaraborg diabetes register (SDR) at diagnosis and after 5years and were analyzed with linear and logistic regressions.


RESULTS
High BMI at diagnosis and smoking were associated with less reduction of HbA1c i.e. poorer treatment outcome after 5years. A high HbA1c at baseline predicted a greater reduction of HbA1c and need for insulin treatment. High systolic blood pressure and BMI at baseline were associated with greater reduction. The biomarkers were not associated with increase of blood pressure, HbA1c, BMI or need for insulin treatment.


CONCLUSIONS
Smokers and patients with high HbA1c at diagnosis respond poorer to treatment over 5years. This highlights the importance of advice for non-smoking and weight reduction and more intensive treatment over time.
Husensjö Health Care Centre, Skaragatan 102, 25363 Helsingborg, Sweden; Center for Primary Health Care Research, Department of Clinical Sciences, Jan Waldenströms gata 35, 205 02 Malmö, Lund University, Sweden. Electronic address: miriam.pikkemaat@med.lu.se.
Miriam
M
Pikkemaat
Department of Medicine, Malmö University Hospital, Södra Förstadsgatan 101, 21428 Malmö, Lund University, Sweden.
Olle
O
Melander
R&D Centre Skaraborg Primary Care, Långgatan 18, 541 30, Skövde, Sweden.
Per
P
Hjerpe
R&D Centre Skaraborg Primary Care, Långgatan 18, 541 30, Skövde, Sweden.
Kristina
K
Bengtsson Boström
D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000517:prevention & control*; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006020:Glycopeptides / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D000073869:Tobacco Smoking / Q000009:adverse effects*
D015415:Biomarkers; D002096:C-Peptide; D006442:Glycated Hemoglobin; D006020:Glycopeptides; C048197:copeptins; C517652:hemoglobin A1c protein, human
Biomarkers; Primary health care; Prognosis; Treatment outcome; Type 2 diabetes mellitus