Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus
Diabetes & Metabolism Journal
; : 284-295, 2017.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-174850
Responsible library:
WPRO
ABSTRACT
BACKGROUND:
Long-term durable glycemic control is a difficult goal in the management of type 2 diabetes mellitus (T2DM). We evaluated the factors associated with durable glycemic control in a real clinical setting.METHODS:
We retrospectively reviewed the medical records of 194 new-onset, drug-naïve patients with T2DM who were diagnosed between January 2011 and March 2013, and were followed up for >2 years. Glycemic durability was defined as the maintenance of optimal glycemic control (glycosylated hemoglobin [HbA1c] <7.0%) for 2 years without substitution or adding other glucose-lowering agents. Clinical factors and glycemic markers associated with glycemic durability were compared between two groups a durability group and a non-durability group.RESULTS:
Patients in the durability group had a higher baseline body mass index (26.1 kg/m² vs. 24.9 kg/m²) and lower HbA1c (8.6% vs. 9.7%) than the non-durability group. The initial choice of glucose-lowering agents was similar in both groups, except for insulin and sulfonylureas, which were more frequently prescribed in the non-durability group. In multiple logistic regression analyses, higher levels of education, physical activity, and homeostasis model assessment of β-cell function (HOMA-β) were associated with glycemic durability. Notably, lower HbA1c (<7.0%) at baseline and first follow-up were significantly associated with glycemic durability (adjusted odds ratio [OR], 7.48; 95% confidence interval [CI], 2.51 to 22.3) (adjusted OR, 9.27; 95% CI, 1.62 to 53.1, respectively), after adjusting for confounding variables including the types of glucose-lowering agents.CONCLUSION:
Early achievement of HbA1c level within the glycemic target was a determinant of long-term glycemic durability in new-onset T2DM, as were higher levels of education, physical activity, and HOMA-β.
Full text:
Available
Health context:
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
Health problem:
Goal 9: Noncommunicable diseases and mental health
/
Target 3.4: Reduce premature mortality due to noncommunicable diseases
Database:
WPRIM (Western Pacific)
Main subject:
Physical Education and Training
/
Body Mass Index
/
Logistic Models
/
Odds Ratio
/
Medical Records
/
Retrospective Studies
/
Follow-Up Studies
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Diabetes Mellitus, Type 2
/
Homeostasis
/
Insulin
Type of study:
Etiology study
/
Observational study
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Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Diabetes & Metabolism Journal
Year:
2017
Document type:
Article