Assessment of baseline characteristics, glycemic control and oral antidiabetic treatment in Asian patients with diabetes: The Registry for Assessing OAD Usage in Diabetes Management (REASON) Asia study.

BACKGROUND: To assess baseline characteristics, glycemic control, and treatment with oral antidiabetic drugs (OAD) in type 2 diabetes mellitus (T2DM) patients. METHODS: This multinational, observational study recruited patients ≥ 21 years of age who were newly diagnosed and/or treated with OAD monotherapy for <6 months but were inadequately controlled. In cross-sectional phase, data on demographics, medical history, diabetic complications and comorbidities, OAD treatment, glycosylated hemoglobin (HbA1c), and fasting blood glucose (FBG) were collected. In longitudinal phase evaluating 6-month follow-up of sulfonylurea (SU)-treated patients, additional data on reasons for not achieving HbA1c targets were collected. RESULTS: Of 1487 patients (mean [± SD] age 52.0 ± 11.6 years; 46.7% men; mean BMI 25.8 ± 4.4 kg/m(2) ) recruited, 75.9% were newly diagnosed, 73.3% had central obesity, 43.8% had hypertension, and 60.5% had dyslipidemia. The mean HbA1c was 9.8 ± 2.4%, and the mean FBG was 11.3 ± 4.3 mmol/L. At T0 (baseline) and T6 (month 6 visit), 99.8% (n=1066) and 97.1% (n=830) patients received SU, respectively. There was decrease from T0 to T6 in mean HbA1c (10.2% vs 7.3%, respectively; P<0.0001) and mean FBG (12.0 vs 7.6 mmol/L, respectively; P<0.0001). Number of patients with HbA1c <7% increased from T0 (4.5%) to T6 (46.8%). Reasons for not achieving target HbA1c included poor diabetes education (50.7%), non-compliance to OADs (21.4%), and fear of hypoglycemia (19.7%). CONCLUSION: Marked reductions in HbA1c and FBG are achievable in T2DM patients managed with OADs. However, patient education and compliance are important for achieving and maintaining treatment targets.

Hormone replacement therapy and bone mineral density: a co-twin approach.

OBJECTIVE: Our objective was to estimate the difference in bone mass at clinically relevant sites within female twin pairs who were discordant for use of hormone replacement therapy (HRT). METHODS: We studied 46 female twin pairs who were discordant for HRT use. Bone mineral content and density were measured at the lumbar spine, total hip, femoral neck, 13 total forearm, and the total body. HRT use, calcium intake, physical activity, alcohol intake, and lifetime smoking were determined by questionnaire. RESULTS: Within a pair, lumbar spine bone mineral density was significantly greater in past and current HRT users compared with nonusers (6.2% +/- 2.0%; P = 0.006). In those pairs who were currently using HRT, the within-pair difference in lumbar spine bone density was 7.8% +/- 2.1% (P = 0.002), and a significant within-pair difference in forearm bone density (5.1 +/- 2.1%; P = 0.02) was apparent. A significant difference (4.6%; P = 0.03) was observed in total body bone mineral content when an adjustment was made for age, lean mass, fat mass, and height. CONCLUSIONS: In keeping with randomized clinical trial findings, these results indicate that HRT in routine clinical use protects significantly against menopausal bone loss at the lumbar spine and the forearm. Our results also quantify the magnitude of the benefit of HRT on bone density that might be anticipated in clinical practice.