Endocrine Abstracts

INTRODUCTION:Diabetes Mellitus is one of the most important problems which has greater health care impact in Spain. It is concluded from the DCCT study on DM1 and UKPDS in DM2 that control of HbA1c levels is essential to reduce chronic complications. Guidelines suggest maintaining HbA1c levels below 7%.

PATIENTS AND METHODS:

Design: Epidemiological, longitudinal, prospective and multicenter study in Spain, with two cohorts, DM1 (n=405) and DM2 (n=374), to obtain information on glycemia control in the clinical practice. A baseline visit, was performed in the study focused on investigating the percentage of controlled and uncontrolled patients according to recommended HbA1c levels.

RESULTS: 405 insulinized patients with DM1 and 374 with DM2, from 128 endocrine setting and 40 primary health care physicians, were assessed. 97.3% with DM2 received drug treatment and the rest only diet. (37%) received sulfonylureas, 9.1% meglitinides, 37.3% biguanides, 7.1% alpha-glucosidase inhibitors, 9.5% thiazoledinediones and 50.4% insulin, in most of cases combined with oral hypoglycemics.

Main baseline data are presented

Number DM1 DM2 ADA

405 374

Mean age 36.31 63.53

Years

Gender 51.5-48.5 54-46

(male-female) %

Uncontrolled

(A1c >75) % 65.7 63.6

HbA1c (%) mean

(SD) 7.56(1.3) 7.49 <7%

(1.3) (1.4)

Percentage

of patients with:

HbA1c <7 34.7% 36.4%

HbA1c 7-8 33.8% 36.9%

HbA1c >8 31.9% 26.7%

Baseline glycemia

(SD) (mg/dl) 164.26 154.53 <110%

(74.6) (54.4)

Postprandial 164.93 182.71 <180%

glycemia (52.5) (57.1)

mg/dl)

The percentage of uncontrolled patients, based on HbA1c levels (ADA recommendations : <7%) is 65.7% in the DM1 cohort and 63.6% in the DM2 cohort, with HbA1c greater than 8% in 31.9% and 26.7% of patients respectively

CONCLUSIONS: This high percentage of uncontrolled patients seems to indicate the need of more intensive intervention to achieve better glycemic control to decrease long term risk of potential complications.