Abstract:
BACKGROUND:The aim of this study was to assess the clinical implications of calculating an individualized HbA1c target using a recently published algorithm in a real-life clinical setting. METHODS:General practitioners (GPs) from the Spanish Society of Family Medicine Diabetes Expert Group were invited to participate in the study. Each GP selected a random sample of patients with diabetes from his or her practice and submitted their demographic and clinical data for analysis. Individualized glycaemic targets were calculated according to the algorithm. Predictors of good glycaemic control were studied. The rate of patients attaining their individualized glycaemic target or the uniform target of HbA1c < 7.0% was calculated. RESULTS:Forty GPs included 408 patients in the study. Of the 8 parameters included in the algorithm, "comorbidities," "risk of hypoglycaemia from treatment," and "diabetes duration" had the greatest impact on determining the individualized glycaemic target. Number of glucose-lowering agents and adherence were independently associated with glycaemic control. Overall, 60.5% of patients had good glycaemic control per individualized target, and 56.1% were well controlled per the uniform target of HbA1c < 7.0% (P = .20). However, 12.8% (23 of 246) of the patients with HbA1c ≥ 7.0% were adequately controlled per individualized target, and 2.6% (6 of 162) of the patients with HbA1c < 7.0% were uncontrolled since their individualized target was lower. CONCLUSIONS:In a real-life clinical setting, applying individualized targets did not change the overall rate of patients with good glycaemic control yet led to reclassification of 7.1% (29 of 408) of the patients. More studies are needed to validate these results in different populations.
journal_name
Diabetes Metab Res Revjournal_title
Diabetes/metabolism research and reviewsauthors
Alvarez-Guisasola F,Cebrián-Cuenca AM,Cos X,Ruiz-Quintero M,Millaruelo JM,Cahn A,Raz I,Orozco-Beltrán D,Spanish Society of Family Medicine Diabetes Group.doi
10.1002/dmrr.2976subject
Has Abstractpub_date
2018-03-01 00:00:00issue
3eissn
1520-7552issn
1520-7560journal_volume
34pub_type
杂志文章abstract:BACKGROUND:A nested case-control (NCC) design within a prospective cohort study can realize substantial benefits for biomarker studies. In this context, it is natural to consider the sample availability in the selection of controls to minimize data loss when implementing the design. However, this violates the randomnes...
journal_title:Diabetes/metabolism research and reviews
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journal_title:Diabetes/metabolism research and reviews
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doi:10.1002/dmrr.540
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journal_title:Diabetes/metabolism research and reviews
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doi:10.1002/dmrr.789
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pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章
doi:10.1002/dmrr.656
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pub_type: 杂志文章
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pub_type: 杂志文章
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