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Relationship between achieved personalized glycaemic targets and monitoring of clinical events in elderly diabetic patients.

Abstract：

AIM:Recent guidelines for the management of type 2 diabetes (T2DM) in the elderly recommend adjusting the therapeutic target (HbA1c) according to the patient's health. Our study aimed to explore the association between achieving the recommended personalized HbA1c target and the occurrence of major clinical events under real-life conditions. METHODS:The T2DM S.AGES cohort was a prospective multicentre study into which 213 general practitioners recruited 983 non-institutionalized T2DM patients aged>65 years. The recommended personalized HbA1c targets were<7%, <8% and <9% for healthy, ill and very ill patients, respectively. Major clinical events (death from any cause, major vascular events and/or hospitalization) were recorded during the 3-year follow-up. Mixed-effects logistic regression models were used for the analyses. RESULTS:Of the 747 patients analyzed at baseline, 551 (76.8%) were at their recommended personalized HbA1c target. During follow-up, 391 patients (52.3%) experienced a major clinical event. Of the patients who did not achieve their personalized HbA1c target (compared with those who did), the risk (OR) of a major clinical event was 0.95 (95% CI: 0.69-1.31; P=0.76). The risk of death, major vascular event and hospitalization were 0.88 (95% CI: 0.40-1.94; P=0.75), 1.14 (95% CI: 0.7-1.83; P=0.59) and 0.84 (95% CI: 0.60-1.18; P=0.32), respectively. CONCLUSION:Over a 3-year follow-up period, our results showed no difference in risk of a major clinical event among patients, regardless of whether or not they achieved their personalized recommended HbA1c target. These results need to be confirmed before implementing a more permissive strategy for treating T2DM in elderly patients.

journal_name

Diabetes Metab

journal_title

Diabetes & metabolism

authors

Bucher S,Panjo H,Al-Salameh A,Bauduceau B,Benattar-Zibi L,Bertin P,Berrut G,Corruble E,Danchin N,Derumeaux G,Doucet J,Falissard B,Forette F,Hanon O,Ourabah R,Pasquier F,Piedvache C,Pinget M,Becquemont L,Ringa V,re

doi

10.1016/j.diabet.2016.05.008

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

59-68

issue

eissn

1262-3636

issn

1878-1780

pii

S1262-3636(16)30417-7

journal_volume

pub_type

杂志文章,多中心研究

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Relationship between achieved personalized glycaemic targets and monitoring of clinical events in elderly diabetic patients.