GOAL study: clinical and non-clinical predictive factors for achieving glycemic control in people with type 2 diabetes in real clinical practice

ObjectiveThe American Diabetes Association and the European Association for the Study of Diabetes guidelines recommend to individualize treatment targets/strategies in inadequately controlled patients by lifestyle management and glucose-lowering drugs to decrease the burden of diabetes-related compl...

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Veröffentlicht in:BMJ open diabetes research & care 2018-07, Vol.6 (1), p.e000519-e000519
Hauptverfasser: Al Mansari, Abdulqawi, Obeid, Youssef, Islam, Najmul, Fariduddin, Mohammed, Hassoun, Ahmed, Djaballah, Khier, Malek, Mojtaba, Dicker, Dror, Chaudhury, Tirthankar
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container_title BMJ open diabetes research & care
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creator Al Mansari, Abdulqawi
Obeid, Youssef
Islam, Najmul
Fariduddin, Mohammed
Hassoun, Ahmed
Djaballah, Khier
Malek, Mojtaba
Dicker, Dror
Chaudhury, Tirthankar
description ObjectiveThe American Diabetes Association and the European Association for the Study of Diabetes guidelines recommend to individualize treatment targets/strategies in inadequately controlled patients by lifestyle management and glucose-lowering drugs to decrease the burden of diabetes-related complications. This real-world practice study aimed to assess predictive factors for achieving the glycemic hemoglobin A1c (HbA1c) at 6 months as targeted by the treating physician in adults with type 2 diabetes who required initiation of basal insulin, initiation of bolus insulin, or modification from basal or premixed insulin to new insulin regimen containing insulin glargine and/or insulin glulisine. Research design and methodsThis was an international, multicenter, observational survey with 12-month follow-up time in adults with type 2 diabetes inadequately controlled conducted in 10 developing countries. ResultsOverall, 2704 patients (mean age: 54.6 years, body mass index: 28.7 kg/m2; Caucasian: 46.1%, type 2 diabetes duration: 10.1 years) with poor glycemic control (mean HbA1c: 9.7% (83 mmol/mol), fasting blood glucose: 196.8 mg/dL) were eligible. At 6 months, advanced age, Caucasian ethnicity, shorter type 2 diabetes duration (>10 vs 1 year, p
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This real-world practice study aimed to assess predictive factors for achieving the glycemic hemoglobin A1c (HbA1c) at 6 months as targeted by the treating physician in adults with type 2 diabetes who required initiation of basal insulin, initiation of bolus insulin, or modification from basal or premixed insulin to new insulin regimen containing insulin glargine and/or insulin glulisine. Research design and methodsThis was an international, multicenter, observational survey with 12-month follow-up time in adults with type 2 diabetes inadequately controlled conducted in 10 developing countries. ResultsOverall, 2704 patients (mean age: 54.6 years, body mass index: 28.7 kg/m2; Caucasian: 46.1%, type 2 diabetes duration: 10.1 years) with poor glycemic control (mean HbA1c: 9.7% (83 mmol/mol), fasting blood glucose: 196.8 mg/dL) were eligible. At 6 months, advanced age, Caucasian ethnicity, shorter type 2 diabetes duration (&gt;10 vs 1 year, p&lt;0.0001), lower baseline HbA1c (≥ 8.5% vs &lt;7%, p&lt;0.0001) and no intake of oral antidiabetic drug (OAD) (none vs 2, p=0.02) were predictive factors for achieving glycemic goal as targeted by the treating physician. Absolute changes in the mean HbA1c of −1.7% and −2% were observed from baseline to 6 and 12 months, respectively. ConclusionsAlong with some well-known predictive factors, this study suggested that early insulin regimen treatment initiation and/or intensification allowed patients to promote glycemic control.</description><identifier>ISSN: 2052-4897</identifier><identifier>EISSN: 2052-4897</identifier><identifier>DOI: 10.1136/bmjdrc-2018-000519</identifier><identifier>PMID: 30023075</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Cardiovascular disease ; Clinical Care/Education/Nutrition ; Clinical medicine ; Diabetes ; Family physicians ; Glucose ; Glucose monitoring ; Hemoglobin ; Insulin ; Patients ; Physicians</subject><ispartof>BMJ open diabetes research &amp; care, 2018-07, Vol.6 (1), p.e000519-e000519</ispartof><rights>Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. 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This real-world practice study aimed to assess predictive factors for achieving the glycemic hemoglobin A1c (HbA1c) at 6 months as targeted by the treating physician in adults with type 2 diabetes who required initiation of basal insulin, initiation of bolus insulin, or modification from basal or premixed insulin to new insulin regimen containing insulin glargine and/or insulin glulisine. Research design and methodsThis was an international, multicenter, observational survey with 12-month follow-up time in adults with type 2 diabetes inadequately controlled conducted in 10 developing countries. ResultsOverall, 2704 patients (mean age: 54.6 years, body mass index: 28.7 kg/m2; Caucasian: 46.1%, type 2 diabetes duration: 10.1 years) with poor glycemic control (mean HbA1c: 9.7% (83 mmol/mol), fasting blood glucose: 196.8 mg/dL) were eligible. 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This real-world practice study aimed to assess predictive factors for achieving the glycemic hemoglobin A1c (HbA1c) at 6 months as targeted by the treating physician in adults with type 2 diabetes who required initiation of basal insulin, initiation of bolus insulin, or modification from basal or premixed insulin to new insulin regimen containing insulin glargine and/or insulin glulisine. Research design and methodsThis was an international, multicenter, observational survey with 12-month follow-up time in adults with type 2 diabetes inadequately controlled conducted in 10 developing countries. ResultsOverall, 2704 patients (mean age: 54.6 years, body mass index: 28.7 kg/m2; Caucasian: 46.1%, type 2 diabetes duration: 10.1 years) with poor glycemic control (mean HbA1c: 9.7% (83 mmol/mol), fasting blood glucose: 196.8 mg/dL) were eligible. 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subjects Cardiovascular disease
Clinical Care/Education/Nutrition
Clinical medicine
Diabetes
Family physicians
Glucose
Glucose monitoring
Hemoglobin
Insulin
Patients
Physicians
title GOAL study: clinical and non-clinical predictive factors for achieving glycemic control in people with type 2 diabetes in real clinical practice
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