Department of Social and Education Policy, University of Peloponnese, Corinth, Greece.
Health Policy Institute, 8, Agisilaou Str, 15123, Maroussi, Athens, Greece.
BMC Endocr Disord. 2020 Jan 28;20(1):16. doi: 10.1186/s12902-020-0496-7.
Strict glycaemic control early in the treatment process has been shown to reduce the occurrence of micro- and macro- vascular complications of diabetes in the long-term. Thus, treatment guidelines advise early intensification of treatment to achieve glycaemic control goals. However, evidence in Greece suggests that, despite guideline recommendations, glycaemic control among patients with T2DM remains challenging. This study presents the demographic and clinical characteristics of patients with T2DM in Greece using data from an electronic registry designed specifically for this treatment category and investigates the factors that are independently associated with glycaemic control.
This is a multi-center, observational, cross-sectional study to investigate epidemiological and clinical factors affecting glycaemic control among patients with T2DM in Greece. Data was collected via a web-based disease registry, the Diabetes Registry, which operated from January 1st to December 31st, 2017. Five large specialized diabetes centers operating in Greek hospitals participated in the study.
Data for 1141 patients were retrieved (aged 63.02 ± 12.65 years, 56.9% male). Glycaemic control (Hb1Ac < 7%) was not achieved in 57.1% of patients. Factors independently associated with poor glycaemic control were: family history of diabetes [OR: 1.53, 95% CI: 1.06-2.23], BMI score between 25 to 30 [OR: 2.08, 95% CI: 1.05-4.13] or over 30 [OR: 2.12, 95% CI 1.12-4.07], elevated LDL levels [OR: 1.53, 95% 1.06-2.21] and low HDL levels [OR: 2.12, 95% CI: 1.44-3.12]. Lastly, use of injectable antidiabetic agents (in monotherapy or in combination) was less likely to be associated with poor glycaemic control versus treatment with combination of oral and injectable agents [OR: 0.50, 95% CI: 0.24-1.01]. This association was found to be marginally statistically significant.
Inadequate lipid control, family history of diabetes and presence of obesity (ΒΜΙ ≥ 30 kg/m) were associated with poor glycaemic control among study sample, whereas use of injectable antidiabetic agents was less likely to be associated with poor glycaemic control. These findings indicate how complex optimal glycaemic control is, highlighting the need for tailored interventions in high-risk subpopulations with T2DM.
在治疗过程的早期进行严格的血糖控制已被证明可以减少糖尿病的微血管和大血管并发症的发生。因此，治疗指南建议早期加强治疗以达到血糖控制目标。然而，希腊的证据表明，尽管有指南建议，但 T2DM 患者的血糖控制仍然具有挑战性。本研究使用专门为该治疗类别设计的电子登记处的数据，介绍了希腊 T2DM 患者的人口统计学和临床特征，并调查了与血糖控制独立相关的因素。
这是一项多中心、观察性、横断面研究，旨在调查影响希腊 T2DM 患者血糖控制的流行病学和临床因素。数据通过一个名为糖尿病登记处的基于网络的疾病登记处收集，该登记处于 2017 年 1 月 1 日至 12 月 31 日运行。在希腊医院运营的五个大型专业糖尿病中心参与了这项研究。
共检索到 1141 例患者的数据（年龄 63.02±12.65 岁，男性占 56.9%）。57.1%的患者血糖控制（Hb1Ac＜7%）未达标。与血糖控制不佳独立相关的因素有：糖尿病家族史[比值比（OR）：1.53，95%置信区间（CI）：1.06-2.23]、BMI 评分在 25 至 30（OR：2.08，95%CI：1.05-4.13）或 30 以上（OR：2.12，95%CI 1.12-4.07）、升高的 LDL 水平（OR：1.53，95%CI 1.06-2.21）和低 HDL 水平（OR：2.12，95%CI：1.44-3.12）。最后，与使用口服和注射联合药物治疗相比，使用胰岛素等注射用抗糖尿病药物（单一疗法或联合疗法）不太可能与血糖控制不佳相关[比值比（OR）：0.50，95%CI：0.24-1.01]。这种关联具有统计学意义上的边缘显著性。
在研究样本中，血脂控制不佳、糖尿病家族史和肥胖（BMI≥30kg/m）与血糖控制不佳相关，而使用胰岛素等注射用抗糖尿病药物与血糖控制不佳的相关性较低。这些发现表明，最佳血糖控制是多么复杂，突出了需要针对 T2DM 的高危亚人群进行有针对性的干预。
