Bała Małgorzata M, Płaczkiewicz-Jankowska Ewa, Leśniak Wiktoria, Topór-Mądry Roman, Jankowski Miłosz, Grzeszczak Władysław, Sieradzki Jacek
II Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland.
Endokrynol Pol. 2014;65(3):158-68. doi: 10.5603/EP.2014.0022.
Previous studies have shown insufficient diabetes control in patients with type 2 diabetes (T2DM). Diabetes Poland changed the target HbA1c and blood pressure (BP) values in diabetic patients in their practice guidelines in 2011, that were further sustained. To assess the management and treatment choices in T2DM of more than ten years' duration and the degree to which diabetic control criteria recommended by the Diabetes Poland clinical practice guidelines 2012 are being met.
ARETAEUS2-Grupa was a cross-sectional questionnaire-based study conducted in Poland in 2012 (April-June). It involved 1,740 patients of any age and both genders, with T2DM diagnosed more than ten years before the study, and recruited by randomly selected physicians.
All patients received pharmacological treatment, most of them combination therapy or insulin in monotherapy. 40% of patients met the goal for HbA1c control (≤ 7%) and the median value of HbA1c was above the recommended threshold (7.2%). Only 8% of thetotal population met all three goals (HbA1c, BP and lipid levels), 26% - two goals, and 40% - only one goal. Over 25% of patients did not meet any of the treatment goals.
We observed considerable deviations from treatment targets recommended by current clinical practice guidelines for patients with T2DM of more than ten years' duration. The frequency of cardiovascular risk factors and late diabetes complications was high, while a relatively high percentage of patients was not examined for late diabetes complications.
先前的研究表明,2型糖尿病(T2DM)患者的糖尿病控制不佳。波兰糖尿病协会在其2011年的实践指南中改变了糖尿病患者的目标糖化血红蛋白(HbA1c)和血压(BP)值,这些目标随后得以维持。旨在评估病程超过十年的T2DM患者的管理和治疗选择,以及波兰糖尿病协会2012年临床实践指南推荐的糖尿病控制标准的达标程度。
ARETAEUS2-Grupa是2012年4月至6月在波兰进行的一项基于问卷调查的横断面研究。研究纳入了1740名任何年龄和性别的患者,他们在研究前十年以上被诊断为T2DM,由随机选择的医生招募。
所有患者均接受了药物治疗,其中大多数采用联合治疗或胰岛素单药治疗。40%的患者达到了HbA1c控制目标(≤7%),HbA1c的中位数高于推荐阈值(7.2%)。在全部人群中,只有8%的患者达到了所有三个目标(HbA1c、血压和血脂水平),26%的患者达到了两个目标,40%的患者仅达到了一个目标。超过25%的患者未达到任何治疗目标。
我们观察到,病程超过十年的T2DM患者与当前临床实践指南推荐的治疗目标存在相当大的偏差。心血管危险因素和糖尿病晚期并发症的发生率很高,而未接受糖尿病晚期并发症检查的患者比例相对较高。