open access

Vol 9, No 3-4 (2008): Practical Diabetology
Original articles (submitted)
Published online: 2008-07-04
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Progress in treatment for type 2 diabetes mellitus based on HbA1c screening in 2002 and 2005

Jacek Sieradzki, Teresa Koblik, Maciej Nazar
Diabetologia Praktyczna 2008;9(3-4):132-139.

open access

Vol 9, No 3-4 (2008): Practical Diabetology
Original articles (submitted)
Published online: 2008-07-04

Abstract

The number of people with diabetes mellitus gradually increases reaching pandemic proportions. Evidence shows the relationship between normalization of diabetes and late complications such as macroangiopathy - atherosclerotic lesions, or microangiopathy - retinopathy and nephropathy. It is also well known that tight glycemic control decreases the risk for diabetic complications. Each 1% reduction of HbA1c, results in a 37% decrease in risk for microangiopathy and a 21% fall in mortality risk. Despite awareness of diabetes consequences there is still a gap between clinical recommendations and practice. It is estimated that 2/3 of diabetics do not achieve the glycemic control target levels. Studies documenting changes in glycemic control over a longer period of time are rare. Data on normalization of diabetes and time trends in Poland are also lacking. The present study was undertaken to answer the following questions:
- has glycemic control changed from 2002 to 2005 as assessed from HbA1c levels in type 2 diabetics;
- have HbA1c levels influenced therapeutic decisionmaking in diabetological practice and how. In 2002 and 2005 patients with type 2 diabetes mellitus underwent screening. Patients with at least 5-year history of diabetes and receiving hypoglycemic agents were enrolled. Each patient in primary care underwent HbA1c measurement and a questionnaire was failled. Then the patients were referred to a diabetologists who decided about further management strategy. The present findings reveal that metabolic control in patients with type 2 diabetes mellitus for at least 5 years as assessed from HbA1c levels did not change significantly from that in 2002 and in 2005 being 7.7% on average, and more than 70% of patients are not adequately controlled. Data obtained from patients receiving insulin therapy reveal that this decision is made much too late, with HbA1c levels being 8.7%. When comparing the 2002 and 2005 data there is a trend toward deciding about initiation of insulin therapy rather than continuing ineffective treatment with oral drugs. For this reason it is necessary to undertake education and organizational changes to facilitate implementation of a model for type 2 diabetic patient care combined with glycemic control target levels as recommended by the Polish Diabetes Association.

Abstract

The number of people with diabetes mellitus gradually increases reaching pandemic proportions. Evidence shows the relationship between normalization of diabetes and late complications such as macroangiopathy - atherosclerotic lesions, or microangiopathy - retinopathy and nephropathy. It is also well known that tight glycemic control decreases the risk for diabetic complications. Each 1% reduction of HbA1c, results in a 37% decrease in risk for microangiopathy and a 21% fall in mortality risk. Despite awareness of diabetes consequences there is still a gap between clinical recommendations and practice. It is estimated that 2/3 of diabetics do not achieve the glycemic control target levels. Studies documenting changes in glycemic control over a longer period of time are rare. Data on normalization of diabetes and time trends in Poland are also lacking. The present study was undertaken to answer the following questions:
- has glycemic control changed from 2002 to 2005 as assessed from HbA1c levels in type 2 diabetics;
- have HbA1c levels influenced therapeutic decisionmaking in diabetological practice and how. In 2002 and 2005 patients with type 2 diabetes mellitus underwent screening. Patients with at least 5-year history of diabetes and receiving hypoglycemic agents were enrolled. Each patient in primary care underwent HbA1c measurement and a questionnaire was failled. Then the patients were referred to a diabetologists who decided about further management strategy. The present findings reveal that metabolic control in patients with type 2 diabetes mellitus for at least 5 years as assessed from HbA1c levels did not change significantly from that in 2002 and in 2005 being 7.7% on average, and more than 70% of patients are not adequately controlled. Data obtained from patients receiving insulin therapy reveal that this decision is made much too late, with HbA1c levels being 8.7%. When comparing the 2002 and 2005 data there is a trend toward deciding about initiation of insulin therapy rather than continuing ineffective treatment with oral drugs. For this reason it is necessary to undertake education and organizational changes to facilitate implementation of a model for type 2 diabetic patient care combined with glycemic control target levels as recommended by the Polish Diabetes Association.
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Keywords

type 2 diabetes mellitus; HbA1c

About this article
Title

Progress in treatment for type 2 diabetes mellitus based on HbA1c screening in 2002 and 2005

Journal

Clinical Diabetology

Issue

Vol 9, No 3-4 (2008): Practical Diabetology

Pages

132-139

Published online

2008-07-04

Bibliographic record

Diabetologia Praktyczna 2008;9(3-4):132-139.

Keywords

type 2 diabetes mellitus
HbA1c

Authors

Jacek Sieradzki
Teresa Koblik
Maciej Nazar

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