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Vol 3, No 6 (2014)
Original articles (submitted)
Published online: 2015-01-20
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Analysis of fulfilling criteria for metabolic control in type 2 diabetic patients treated in the Endocrinology Clinic at the Medical University of Lublin in the years 2006–2011

Agnieszka Łagowska-Batyra, Grzegorz Rudzki, Beata Matyjaszek-Matuszek, Agata Smoleń, Mariusz Jasik, Andrzej Nowakowski
Diabetologia Kliniczna 2014;3(6):246-255.

open access

Vol 3, No 6 (2014)
Original articles (submitted)
Published online: 2015-01-20

Abstract

Background. Chronic macro- and microangiopathic complications of type 2 diabetes still constitute an unsolved problem. They are often identified at diagnosis, which results in worse quality of life of the patients and limits the treatment. Prospective studies have shown that preventing hyperglycemic effects by accomplishing goals recommended for diabetic patients, self-control and appropriate treatment could reduce the incidence of complications and treatment costs. Therefore, it has become a worldwide practice to determine the standards, recommendations or instructions the patients should follow. In Poland, complex and multicentre Recommendations were first published in 2005 and have been annually updated ever since. The main aim of the study was a comparative evaluation of meeting metabolic control criteria by type 2 diabetes patients in 2006 and 2011.

Materials and methods. 1,045 patients (476 males, 45.5%) hospitalized in the Department of Endocrinology of the Medical University of Lublin were studied. Biochemical parameters included basic metabolic control criteria, i.e. fasting glucose, HbA1c and lipid profile fractions. Mean systolic and diastolic pressure was also determined.

Results. Triglycerides concentration (50.4%) was the most frequently met criterion of those recommended by the PTD in 2006, whereas HbA1c concentration (12.1%) was the least frequent one. However, following the 2011 recommendations, diastolic arterial pressure was the most frequently met criterion (66.9%), whereas the concentration of LDL-cholesterol fraction in individuals with coexistent ischaemic heart disease (IHD) (18.7%) was the least frequent one. The next stage involved a comparative analysis of meeting consecutive metabolic control criteria recommended by the PDD. It was found that 0.4% of the patients (n = 3) without coexistent IHD met all the metabolic control criteria in 2006, whereas no patient with coexistent IHD met all metabolic control criteria. A significant (p < 0.001) percentage (1.6%) of the patients (n = 5) with coe­xistent IHD and 3.0% of individuals (n = 22) without coexistent IHD met all 2011 metabolic control criteria.

Conclusions. 1. When comparing the criteria for metabolic control in 2006 and 2011 we can observe that they have become more relaxed and individualised. However, the change has not resulted in the full achievement of the PTD’s therapeutic goals. On the other hand, the number of the patients who meet for both all criteria at the same time, as well as single criterion including HbA1c and blood pressure, has risen. 2. The degree of meeting the PTD’s criteria for metabolic control is unsatisfactory, irrespective of the ones applied.

Abstract

Background. Chronic macro- and microangiopathic complications of type 2 diabetes still constitute an unsolved problem. They are often identified at diagnosis, which results in worse quality of life of the patients and limits the treatment. Prospective studies have shown that preventing hyperglycemic effects by accomplishing goals recommended for diabetic patients, self-control and appropriate treatment could reduce the incidence of complications and treatment costs. Therefore, it has become a worldwide practice to determine the standards, recommendations or instructions the patients should follow. In Poland, complex and multicentre Recommendations were first published in 2005 and have been annually updated ever since. The main aim of the study was a comparative evaluation of meeting metabolic control criteria by type 2 diabetes patients in 2006 and 2011.

Materials and methods. 1,045 patients (476 males, 45.5%) hospitalized in the Department of Endocrinology of the Medical University of Lublin were studied. Biochemical parameters included basic metabolic control criteria, i.e. fasting glucose, HbA1c and lipid profile fractions. Mean systolic and diastolic pressure was also determined.

Results. Triglycerides concentration (50.4%) was the most frequently met criterion of those recommended by the PTD in 2006, whereas HbA1c concentration (12.1%) was the least frequent one. However, following the 2011 recommendations, diastolic arterial pressure was the most frequently met criterion (66.9%), whereas the concentration of LDL-cholesterol fraction in individuals with coexistent ischaemic heart disease (IHD) (18.7%) was the least frequent one. The next stage involved a comparative analysis of meeting consecutive metabolic control criteria recommended by the PDD. It was found that 0.4% of the patients (n = 3) without coexistent IHD met all the metabolic control criteria in 2006, whereas no patient with coexistent IHD met all metabolic control criteria. A significant (p < 0.001) percentage (1.6%) of the patients (n = 5) with coe­xistent IHD and 3.0% of individuals (n = 22) without coexistent IHD met all 2011 metabolic control criteria.

Conclusions. 1. When comparing the criteria for metabolic control in 2006 and 2011 we can observe that they have become more relaxed and individualised. However, the change has not resulted in the full achievement of the PTD’s therapeutic goals. On the other hand, the number of the patients who meet for both all criteria at the same time, as well as single criterion including HbA1c and blood pressure, has risen. 2. The degree of meeting the PTD’s criteria for metabolic control is unsatisfactory, irrespective of the ones applied.

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Keywords

type 2 diabetes, metabolic control criteria, HbA1c, lipid profile, arterial blood pressure

About this article
Title

Analysis of fulfilling criteria for metabolic control in type 2 diabetic patients treated in the Endocrinology Clinic at the Medical University of Lublin in the years 2006–2011

Journal

Clinical Diabetology

Issue

Vol 3, No 6 (2014)

Pages

246-255

Published online

2015-01-20

Bibliographic record

Diabetologia Kliniczna 2014;3(6):246-255.

Keywords

type 2 diabetes
metabolic control criteria
HbA1c
lipid profile
arterial blood pressure

Authors

Agnieszka Łagowska-Batyra
Grzegorz Rudzki
Beata Matyjaszek-Matuszek
Agata Smoleń
Mariusz Jasik
Andrzej Nowakowski

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