Glycemic Control in 115 Type 2 Diabetic Patients: a Real-World 3 Year Experience

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 776-795-Cardiometabolic Risk & Vascular Biology
Clinical
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-793
Tiago Lopes Nunes da Silva*, Henrique Vara Luiz, Bernardo Dias Pereira, Andreia Veloza, Ana Catarina Matos, Isabel Manita, Maria Carlos Cordeiro, Luísa Raimundo and Jorge Portugal
Garcia de Orta Hospital, Almada, Portugal
Glycemic control in patients with type 2 diabetes (DM2) usually worsens over time, requiring intensification of therapy.

The authors assessed the evolution of glycemic control, DM2 therapy and its effects on weight on 115 DM2 patients on the first 3 years of follow up at an Endocrinology Center. One-way ANOVA or paired t-test were used to study normally distributed variables.

At baseline, median duration of diabetes was 7 years, mean age 60,5 years (+/-10), HbA1c 9,4% (+/-2,3) and weight 75,7 Kg (+/-17). Self monitoring of blood glucose (SMBG) was performed adequately by 48.7% of patients. Initial therapy consisted in lifestyle measures only in 4,3%, oral agents (OA) without insulin in 60% (metformin plus sulfonylurea in 32,9%, sulfonylurea in 24,4% and metformin in 22%) and insulin in 27,8% (70% with NPH, 23,3% with mixture and 6,6% with glargine).

At the end of the third year, SMBG was performed adequately by 73% (p<0,01). No patient stayed on lifestyle measures only; there was a decrease in OA without insulin to 28.7% (metformin in 35%, metformin with ddp4 inhibitor in 21% and metformine plus sulfonylurea plus dpp4 inhibitor in 16,7%), and an increase in insulin containing therapies to 71,3% (44,8% with NPH, 33,8% with mixture, 15% with glargine and 7,5% with detemir) (p<0,05).

The HbA1c decreased to 7,4% (+/-1,1) (p<0,001) and weight increased to 81,5 Kg (+/-17,2) (p<0,001). During this period, no major hypoglycemic events were observed. The magnitude of improvements in HbA1c was different depending on treatment groups: patients who stayed on OA improved 1%, patients who were kept on insulin improved 2,5% and patients who switched to insulin improved 3,2% (p<0.05).

There was a significant improvement in SMBG and glycemic control over 3 years of follow up at the Endocrinology Center. This occurred along with an increase in the use of insulin based therapies. Although an average increase in weight of 1,9 Kg/year was observed, there was no significant increase in major hypoglycemic events.

Nothing to Disclose: TLN, HVL, BDP, AV, ACM, IM, MCC, LR, JP

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm