CENEXA   05419
CENTRO DE ENDOCRINOLOGIA EXPERIMENTAL Y APLICADA
Unidad Ejecutora - UE
congresos y reuniones científicas
Título:
Results of the International Diabetes Management Practices Study (IDMPS), year 2: baseline characteristics and trealment regimens in patients with type 2 diabetes
Autor/es:
BAIK SH; GAGLIARDINO JJ; ON BEHALF OF THE LDMPS GROUP
Lugar:
Amsterdam
Reunión:
Congreso; 43rd EASD Annual Meeting of the European Association for the Study of Diabetes; 2007
Institución organizadora:
European Association for the Study of Diabetes
Resumen:
Background and Aims: Despite the evidence provided by the UKPDS and the recommendations of the ADA, EASD and IDF, a large number of patients with diabetes are not well controlled. In this regard, our aim was to gather data on current practices in the management of patients with diabetes worldwide and to evaluate the degree of compliance wilh international guidelines. Material and Methods: The IDMPS is an international, multicenter, observational study performed in 27 countries within Africa, Asia, Eastern, Europe, the Middle East and Latin America. Data are being collected from Type 1 and Type 2 diabetic patients (¡Ý18 years) seen in current medical practice in 1-year cycles (a 2-week cross-sectional recruitment period,followed by a 9-month longitudinal period for Type 2 patients) for 5 years. Here, we report results for patients with Type 2 diabetes collected during the second cross-sectional period (Year 2) in 8 countries. Data were analyzed using standard descriptive methods. Results: Overall, 4312 patients with Type 2 diabetes (47.8% men), were recruited during November and December 2006. The mean age was 58.3¡À11.2 years, mean BMl 27.4¡À4.4 kg/m2 for men and 28.4¡À5.6 kg/m2 for women and mean disease duration 8.3¡À7.5 years. The mean last available HbA1c was 8.0¡À2.0% and 32.7% of patients had an HbA1c <7%. The mean last available FBG (laboratory) was 158.8¡À64.0 mg/dL. Mean systolic/diastolic blood pressure was 134/80 mmHg. Target treatment levels were achieved for LDL (< 100 mg/dL) in 32.5% of patients, for HDL (>40 mg/dL) in 62.0%, and for triglyceride (< 150 mg/dL) in 53.8%. A regimen of diet and exercise was reported in 3.6% of patients (mean HbA1c: 7.4¡À1.7%). Among patients treated with oral glucose lowering drugs (OGLD) only (66.9%; mean HbA1c: 7.8¡À1.9%), combined therapy was more frequent than monotherapy (59.7% vs. 40.3%), the preferred combination being sulphonylureas + metformin (more than 80%), and 10.4% of patients received more than two OGLD. Among patients treated with both OGLD and insulin (15.7%; mean HbA1c: 8.7¡À2.1 %; mean insulin dose: 0.46¡À0.28 U/kg), the mean time since start of insulin therapy was 3.0¡À3.8 years. The association of OGLD and premixed insulin (mean daily dose: 0.56¡À0.20 U/kg) was observed in 37.6% of OGLD+insulin treated-patients, and that of OGLD and basal insulin in 60.2% (of whom 10.2% had prandial+basal insulin; mean daily dose of basal insulin alone: 0.33¡À0.20 U/kg; basal + prandial: 0.38¡À0.20 U/kg). Among patients treated with insulin only (13.8%; mean HbA1c: 8.4¡À2.1%; mean insulin dose: 0.75¡À0.30 U/kg), premixed insulin alone was used in 49.2% of patients, basal insulin alone in 26.3%, basal+prandial insulin in 18.5% and prandial insulin alone in 204%. The percentage of patients reaching target HbA1c< 7% was 37.2% in patients receiving OGLD alone, 16.9% in those receiving OGLD + basal insulin, 19.6% in those receiving OGLD+basal+prandial insulin and 21.3% in those receiving OGLD+premixed insulin. Conclusion: Our data show that the majority of Type 2 patients analyzed did not achieve the recommended treatment goals for HbA1c, and FBG. Thus, measures designed to improve these results are urgently needed to reduce the current and future increases in the demand for care and the costs resulting from this poor diabetes control worldwide. Supported by an unrestricted grant from sanofi-aventis