Clinical and epidemiological evaluation of type 2 diabetic patients treated with extended-release metformin. EpiDiaMet Study

Abstract

Introduction. Optimal metabolic control is crucial for the prevention of diabetic complications, considered one of the most important problems of current medi­cine. Aims of the work: 1. epidemiological assessment of type 2 diabetic patients treated with extended­-release metformin; 2. assessment of parameters for diabetes control after a 3-month observation, during which physicians treated patients according to local practice; 3. comparison with other epidemiological analyses, ARETAEUS1 and OPTIMO completed in Poland in the last years. Material and methods. A total of 1767 type 2 dia­betic patients with poor metabolic control, treated with extended-release metformin, who presented in a general practitioner office for routine control visit (15 consecutive patients) were included. Mean age (± SD) was 59 ± 11 years, mean diabetes duration 5 ± 7 years. Data on metabolic control and diabetic complications were collected at baseline and after 3 months, using a specific questionnaire. Data were compared to ARETAEUS1 and OPTIMO analyses. Results. After 3 months observation glycated hemoglo­bin decreased from 7.58 ± 3.14 to 7.38 ± 8.49 (p < 0.02). Blood pressure (systolic/diastolic) decreased from 138 ± 18/85 ± 22 to 130 ± 34/80 ± 10 mm Hg (p < 0.001). Statistically significant (p < 0.001) improve­ments in lipids parameters were also recorded: baseline mean (± SD) total cholesterol level decreased: before 5.67 ± 2.24 and after 5.19 ± 3.42 mmol/l; low-density lipoprotein (LDL) cholesterol level decreased: before 3.47 ± 1.79 and after 3.11 ± 2.00 mmol/l; high-density lipoprotein (HDL) cholesterol level increased from 1.23 ± 0.38 to 1.30 ± 0.36 mmol/l. At baseline 14% of patients received a high dose (2000 mg or higher) of extended release metformin and after 3 months of observation the percentage rose to 34%. Conclusions. The reported EpiDiaMet study, conducted in type 2 diabetic patients with short duration of diabetes, treated with extended-release metformin indicates the need for treatment intensification and maximization of metformin doses.