Real-World Adequacy of Glycaemic Control in Treatment-Naive Greek Patients with Type 2 Diabetes Mellitus Initiating Treatment with Metformin Monotherapy at the Maximum Tolerated Dose: The Reload Study

被引:1
|
作者
Tsimihodimos, Vasilis [1 ]
Bargiota, Alexandra [2 ]
Pagkalos, Emmanouil M. [3 ]
Manes, Christos [4 ]
Papas, Aggelos [5 ]
Karamousouli, Eugenia [6 ]
Voss, Bernd [7 ]
Elisaf, Moses S. [1 ]
机构
[1] Univ Ioannina, Sch Med, Dept Internal Med, Ioannina 45500, Greece
[2] Univ Thessaly, Dept Endocrinol & Metab Dis, Sch Med, Larisa, Greece
[3] Private Hosp Thermi Clin, Thessaloniki, Greece
[4] Papageorgiou Gen Hosp, Diabet Ctr, Thessaloniki, Greece
[5] Venizelio Gen Hosp Heraklion, Diabet Ctr, Iraklion, Greece
[6] Merck Sharp & Dohme MSD, Athens, Greece
[7] MSD RBSC, Lindenpl 1, Darmstadt, Germany
关键词
clinical inertia; glycaemic control; metformin; type 2 diabetes mellitus; BLOOD-GLUCOSE CONTROL; TREATMENT INTENSIFICATION; CLINICAL INERTIA; EFFICACY; PEOPLE; COMPLICATIONS; SULFONYLUREAS; ASSOCIATION; SITAGLIPTIN; MANAGEMENT;
D O I
10.1055/a-0824-6607
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Metformin, in the absence of contraindications or intolerance, is recommended as first-line treatment for patients with type 2 diabetes mellitus (T2DM). This observational, retrospective study assessed the real-world adequacy of glycaemic control in Greek patients with T2DM initiating metformin monotherapy at maximum tolerated dose. Methods Included patients received metformin monotherapy for >= 24 months; relevant patient data were collected immediately prior to metformin initiation (baseline) and at other prespecified time points. The primary objective was to report, after 9 months of metformin treatment, the percentage of patients with baseline glycated haemoglobin (HbA(1c)) levels >= 6.5 % (>= 48 mmol/mol) achieving HbA(1c) <6.5 %. Secondary objectives included the assessment of time spent with poor glycaemic control and time to treatment intensification. A sensitivity analysis assessed the percentage of patients with base- line HbA(1c) >= 7 % (>= 53 mmol/mol) achieving HbA(1c) < 7 % (<53 mmol/mol). Results Of the enrolled patients (N =316), 247 had baseline HbA(1c) >= 6.5%; following 9 months on metformin, 90 (36.4%) patients achieved HbA(1c) >= 6.5 % (mean HbA(1c) change- 1.3 % [ - 14 mmol/mol]). Median time of exposure to HbA(1c) >= 6.5% was 23.4 months and time to treatment intensification was 28.0 months. The sensitivity analysis revealed thatthe proportion of patients achieving HbA(1c) < 7.0 % was 50% (mean HbA(1c) change -1.6% [ -17 mmol/mol]). Conclusion Irrespective of HbA(1c) target assessed, most patients with T2DM do not achieve the recommended HbA(1c) goals after 9 months on metformin while remained on monotherapy for up to 24 months. Addressing clinical inertia could improve disease outcomes and, possibly, economic burden.
引用
收藏
页码:224 / 230
页数:7
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