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A retrospective analysis of the fasting plasma glucose and glycosylated hemoglobin and pharmacotherapy change patterns among type 2 diabetes mellitus patients.
Clin Ther. 2008 Feb; 30(2):287-93.CT

Abstract

OBJECTIVE

The aim of this study was to describe glycemic control levels (fasting plasma glucose [FPG] and glycosylated hemoglobin [HbA(1c)]) and pharma-cotherapy change patterns among a cohort of patients with type 2 diabetes mellitus (T2DM) receiving various antidiabetic agents.

METHODS

This study, a retrospective analysis conducted from a large electronic medical record database, identified T2DM patients with > or =1 prescription for metformin, sulfonylureas, or thiazolidinediones from January 23, 1997, through March 15, 2006. The database contained medical and clinical records of patients-including diagnoses, medications, laboratory results, and physician orders-linked through encrypted patient identifiers. This study calculated the mean and median FPG and HbA(1c) values (performed within 30 days before or after a pharmacotherapy change) and the percentage of patients with values above those recommended by the American Diabetes Association (ADA) and the American College of Endocrinology (ACE)/American Association of Clinical Endocrinologists(AACE).

RESULTS

The study included a total of 7769 T2DM patients (3942 female/3827 male; 56.9% were aged 50-69 years). For patients with no pharmacotherapy change, most did not achieve the ADA recommendations for FPG (56.4% [1917/3398]) or HbA(1c) (48.6% [952/1958]) or the ACE/AACE recommendations forFPG (79.4% [2698/3398]) or HbA(1c) (65.4% [1281/1958]). These patients' mean FPG level was 151.9 mg/ dL (95% CI, 150.0-153.9 mg/dL) and their mean HbA(1c) value was 7.51% (95% CI, 7.43%-7.60%). For patients with a pharmacotherapy change, the mean FPG level was 191.1 mg/dL (95% CI, 186.7-195.4 mg/dL) and the mean HbA(1c) value was 8.85% (95% CI, 8.70%-9.00%). Similar to those with no pharmacotherapy change, a large percentage of patients with a pharmacotherapy change did not achieve the ADA recommendations for FPG (77.7% [1107/1425]) or HbA(1c) (76.2% [753/988]) or the ACE/AACE recommendations for FPG (90.1% [1284/1425]) or HbA(1c) (88.5% [874/988]).

CONCLUSION

Despite the proven benefits of maintaining glycemic control and its impact on reducing long-term risk of diabetes complications, these results indicate that the mean FPG and HbA(1c) values for a large percentage of diabetic patients included in this study remained above those recommended by the ADA and the ACE/AACE.

Authors+Show Affiliations

University of Texas Southwestern Medical School, Dallas, Texas, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18343267

Citation

Davidson, Jaime, et al. "A Retrospective Analysis of the Fasting Plasma Glucose and Glycosylated Hemoglobin and Pharmacotherapy Change Patterns Among Type 2 Diabetes Mellitus Patients." Clinical Therapeutics, vol. 30, no. 2, 2008, pp. 287-93.
Davidson J, Koro C, Arondekar B, et al. A retrospective analysis of the fasting plasma glucose and glycosylated hemoglobin and pharmacotherapy change patterns among type 2 diabetes mellitus patients. Clin Ther. 2008;30(2):287-93.
Davidson, J., Koro, C., Arondekar, B., Lee, B. H., & Fedder, D. (2008). A retrospective analysis of the fasting plasma glucose and glycosylated hemoglobin and pharmacotherapy change patterns among type 2 diabetes mellitus patients. Clinical Therapeutics, 30(2), 287-93. https://doi.org/10.1016/j.clinthera.2008.02.007
Davidson J, et al. A Retrospective Analysis of the Fasting Plasma Glucose and Glycosylated Hemoglobin and Pharmacotherapy Change Patterns Among Type 2 Diabetes Mellitus Patients. Clin Ther. 2008;30(2):287-93. PubMed PMID: 18343267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A retrospective analysis of the fasting plasma glucose and glycosylated hemoglobin and pharmacotherapy change patterns among type 2 diabetes mellitus patients. AU - Davidson,Jaime, AU - Koro,Carol, AU - Arondekar,Bhakti, AU - Lee,Bo Hyen, AU - Fedder,Donald, PY - 2007/12/18/accepted PY - 2008/3/18/pubmed PY - 2009/9/9/medline PY - 2008/3/18/entrez SP - 287 EP - 93 JF - Clinical therapeutics JO - Clin Ther VL - 30 IS - 2 N2 - OBJECTIVE: The aim of this study was to describe glycemic control levels (fasting plasma glucose [FPG] and glycosylated hemoglobin [HbA(1c)]) and pharma-cotherapy change patterns among a cohort of patients with type 2 diabetes mellitus (T2DM) receiving various antidiabetic agents. METHODS: This study, a retrospective analysis conducted from a large electronic medical record database, identified T2DM patients with > or =1 prescription for metformin, sulfonylureas, or thiazolidinediones from January 23, 1997, through March 15, 2006. The database contained medical and clinical records of patients-including diagnoses, medications, laboratory results, and physician orders-linked through encrypted patient identifiers. This study calculated the mean and median FPG and HbA(1c) values (performed within 30 days before or after a pharmacotherapy change) and the percentage of patients with values above those recommended by the American Diabetes Association (ADA) and the American College of Endocrinology (ACE)/American Association of Clinical Endocrinologists(AACE). RESULTS: The study included a total of 7769 T2DM patients (3942 female/3827 male; 56.9% were aged 50-69 years). For patients with no pharmacotherapy change, most did not achieve the ADA recommendations for FPG (56.4% [1917/3398]) or HbA(1c) (48.6% [952/1958]) or the ACE/AACE recommendations forFPG (79.4% [2698/3398]) or HbA(1c) (65.4% [1281/1958]). These patients' mean FPG level was 151.9 mg/ dL (95% CI, 150.0-153.9 mg/dL) and their mean HbA(1c) value was 7.51% (95% CI, 7.43%-7.60%). For patients with a pharmacotherapy change, the mean FPG level was 191.1 mg/dL (95% CI, 186.7-195.4 mg/dL) and the mean HbA(1c) value was 8.85% (95% CI, 8.70%-9.00%). Similar to those with no pharmacotherapy change, a large percentage of patients with a pharmacotherapy change did not achieve the ADA recommendations for FPG (77.7% [1107/1425]) or HbA(1c) (76.2% [753/988]) or the ACE/AACE recommendations for FPG (90.1% [1284/1425]) or HbA(1c) (88.5% [874/988]). CONCLUSION: Despite the proven benefits of maintaining glycemic control and its impact on reducing long-term risk of diabetes complications, these results indicate that the mean FPG and HbA(1c) values for a large percentage of diabetic patients included in this study remained above those recommended by the ADA and the ACE/AACE. SN - 1879-114X UR - https://www.unboundmedicine.com/medline/citation/18343267/A_retrospective_analysis_of_the_fasting_plasma_glucose_and_glycosylated_hemoglobin_and_pharmacotherapy_change_patterns_among_type_2_diabetes_mellitus_patients_ DB - PRIME DP - Unbound Medicine ER -