Vol 12, No 5 (2011): Practical Diabetology
Research paper
Published online: 2011-12-29

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CONTROL-DIAB: an assessment of glycaemic control in patients with type 2 diabetes mellitus managed in the outpatient setting

Dariusz Naskręt, Agnieszka Ochwat, Łukasz Borowiec, Bogna Wierusz-Wysocka
Diabetologia Praktyczna 2011;12(5):188-194.


BACKGROUND. Standards and appropriate recommendations have been developed with the view of improving medical care provided to patients with diabetes mellitus. Previously studies conducted suggest that the most important factor affecting the course of type 2 diabetes mellitus (T2DM) is its appropriate and effective treatment in the first years after the diagnosis. The aim of the study was to assess the compliance with the recommendations of the Polish Diabetes Association in a group of patients with a short duration of T2DM.
MATERIAL AND METHODS. This was a nationwide, non-interventional, observational study investigating 3566 patients with 1–5 year long T2DM duration, aged 40–70 years, with a BMI exceeding 25 kg/m2, managed in the outpatient setting with lifestyle interventions and/or metformin and/or acarbose. During two study visits (V1 and V2) 463 doctors employed at general practices or diabetes clinics modified the patients’ management plans or left them unchanged. Their decision was based on the history, physical examination and laboratory tests.
RESULTS. During V1, the criteria of good glycaemic control based on HbA1c levels were met by 27.2% of the patients (HbA1c 7.4% ± 1.0%). Most patients were initially managed with metformin at the dose of 1684 ± 675 mg/day. Baseline fasting glucose was 134.5 ± 26.8 mg/dl and was significantly lower during V2 (113.6 ± 17.5 mg/dl). The management plan was modified in most of the patients. Intensification of treatment involved adding a sulfonylurea (gliclazide modified-release tablets) to metformin or often replacing biguanides with this product.
CONCLUSIONS. 1. Most patients with a short duration of T2DM who participated in our study did not meet the criteria for good glycaemic control recommended by the PTD. 2. In overweight or obese patients with T2DM, despite poor glycaemic control, maximum doses of metformin were not given. 3. Intensification of the treatment in T2DM too frequently involves switching to another drug class rather than adding to present therapies a product characterised by a different mechanism of action. (Diabet. Prakt. 2011; 12, 5: 188–194)

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