Factors associated with a rapid normalization of HbA1c in newly diagnosed type 2 diabetes patients seen in a specialist setting

被引:5
作者
Giorda, C. B. [1 ]
Mulas, M. F. [2 ]
Manicardi, V. [3 ]
Suraci, C. [4 ]
Guida, P. [5 ]
Marafetti, L. [1 ]
Nada, E. [6 ]
Gentile, S. [7 ]
机构
[1] ASL, Metab & Diabet Unit, Turin 5, Italy
[2] Metab & Diabet Unit, Oristano, Italy
[3] Montecchio Hosp, Montecchio Emilia, Italy
[4] Pertini Hosp, Metab & Diabet Unit, Rome, Italy
[5] Univ Bari, Emergency & Organ Transplantat Dept, Cardiol Unit, Bari, Italy
[6] Chaira Med Assoc, Chieri, Italy
[7] Univ Naples Federico II, Naples, Italy
关键词
HbA1c normalization; Type 2 diabetes treatment; Organizational factors; Clinical factors; CARE; COMPLICATIONS; INTERVENTION; ONSET; TEAM;
D O I
10.1007/s00592-012-0431-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The time to achieve good metabolic control after diagnosis is essential for type 2 diabetes patients because it can influence long-term prognosis. This study aimed to elucidate the predictive role of several clinical and organization factors in normalizing metabolism within 6 months. A multi-centered, retrospective, observational study on 960 patients, with diabetes duration of 12 months or less, consecutively seen in 123 Italian clinics, was undertaken. Information about clinic's organization, along with data abstracted from medical records at enrollment (first visit) and after 6 months (follow-up visit), was collected. At 6 months, HbA1c dropped by -3.1 +/- A 2.2 points in those who achieved HbA1c < 7 % (responders), whereas in non-responders (HbA1c a parts per thousand yen7 %), the mean reduction was -1.8 +/- A 1.9. The intervention markedly reduced lipids, blood pressure, BMI, and waist circumference, especially in responders. The presence of a diabetes team correlated with a likelihood of HbA1c normalization (OR 1.94, 1.17-3.22). By contrast, indicators of advanced disease such as previous retinopathy (0.53, 0.29-0.98), use of secretagogues (0.40, 0.25-0.64), high levels of HbA1c at first visit and related insulin use emerged as adverse factors. Early detection of diabetes, along with human resources and organization, was found to play a crucial role in rapidly attaining good metabolic control.
引用
收藏
页码:81 / 87
页数:7
相关论文
共 20 条
[1]  
American Diabetes Association, 2010, DIABETES CARE S, V33
[2]  
[Anonymous], 2008, ACTA DIABETOL
[3]   The "Metabolic Memory": Is More Than Just Tight Glucose Control Necessary to Prevent Diabetic Complications? [J].
Ceriello, Antonio ;
Ihnat, Michael A. ;
Thorpe, Jessica E. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2009, 94 (02) :410-415
[4]   The effect of intensive glycemic treatment on coronary artery calcification in type 1 diabetic participants of the diabetes control and complications Trial/Epidemiology of diabetes interventions and complications (DCCT/EDIC) study [J].
Cleary, Patricia A. ;
Orchard, Trevor J. ;
Genuth, Saul ;
Wong, Nathan D. ;
Detrano, Robert ;
Backlund, Jye-Yu C. ;
Zinman, Bernard ;
Jacobson, Alan ;
Sun, Wanjie ;
Lachin, John M. ;
Nathan, David M. .
DIABETES, 2006, 55 (12) :3556-3565
[5]   Screening for type 2 diabetes [J].
Engelgau, MM ;
Narayan, KMV ;
Herman, WH .
DIABETES CARE, 2000, 23 (10) :1563-1580
[6]   Effect of a multifactorial intervention on mortality in type 2 diabetes [J].
Gaede, Peter ;
Lund-Andersen, Henrik ;
Parving, Hans-Henrik ;
Pedersen, Oluf .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 358 (06) :580-591
[7]   Association of physicians' accuracy in recording with quality of care in cardiovascular medicine [J].
Giorda, Carlo Bruno ;
Guida, Piero ;
Avogaro, Angelo ;
Cortese, Claudio ;
Mureddu, Gian Francesco ;
Corsini, Alberto ;
Comaschi, Marco Antonio ;
Manzato, Enzo ;
Volpe, Massimo ;
Zito, Giovanni Battista ;
Medea, Gerardo ;
Ventriglia, Giuseppe ;
Titta, Giulio ;
Riccardi, Gabriele .
EUROPEAN JOURNAL OF CARDIOVASCULAR PREVENTION & REHABILITATION, 2009, 16 (06) :722-728
[8]   Determinants of Quality in Diabetes Care Process The population-based Torino Study [J].
Gnavi, Roberto ;
Costa, Giuseppe ;
Picariello, Roberta ;
Giorda, Carlo ;
la Karaghiosoff, Ludmi .
DIABETES CARE, 2009, 32 (11) :1986-1992
[9]   ONSET OF NIDDM OCCURS AT LEAST 4-7 YR BEFORE CLINICAL-DIAGNOSIS [J].
HARRIS, MI ;
KLEIN, R ;
WELBORN, TA ;
KNUIMAN, MW .
DIABETES CARE, 1992, 15 (07) :815-819
[10]   10-year follow-up of intensive glucose control in type 2 diabetes [J].
Holman, Rury R. ;
Paul, Sanjoy K. ;
Bethel, M. Angelyn ;
Matthews, David R. ;
Neil, H. Andrew W. .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 359 (15) :1577-1589