Inadequate glycaemic control and antidiabetic therapy among inpatients with type 2 diabetes in Guangdong Province of China

Background Diabetes mellitus has become epidemic in recent years in China. We investigated the prevalence of hyperglycaemia and inadequate glycaemic control among type 2 diabetic inpatients from ten university teaching hospitals in Guangdong Province, China. Methods Inadequate glycaemic control in diabetic patients was defined as HbA1c 〉 6.5%. Therapeutic regimens included no-intervention, lifestyle only, oral antiglycemic agents （OA）, insulin plus OA （insulin＋OA）, or insulin only. Antidiabetic managements included monotherapy, double therapy, triple or quadruple therapy. Results Among 493 diabetic inpatients with known history, 75% had HbA1c ≥ 6.5%. inadequate glucose control rates were more frequently seen in patients on insulin＋OA regimen （97%） ,than on OA regimen （71%） （P 〈0.001）, and more frequent in patients on combination therapy （81%-96%） than monotherapy （7,5%） （P 〈0.0,5）. Patients on insulin differed significantly from patients on OA by mean HbA1c, glycemic control rate, diabetes duration, microvascular complications, and BMI （P 〈0.01）. Conclusions This study showed that glycaemic control of type 2 diabetic patients deteriorated for patients who received insulin and initiation time of insulin was usually delayed, it is up to clinicians to move from the traditional stepwise therapy to a more active and early combination antidiabetic therapy to provide better glucose control.