Achieving target values for measures for peripheral arterial disease, nephropathy and dyslipidemia in type 2 diabetes- two year assessment

Ragini Rohatgi; Sonali Ghodke; Daisy Alfred

doi:10.1530/endoabs.73.AEP309

Objective

T2DM is a major risk factor of peripheral artery disease, leading to increased morbidity and mortality as well as an accelerated disease course. Microalbuminuria is an indicator for overt nephropathy and early cardiovascular disease

Methods

We analysed data from outpatients attending a comprehensive diabetes care centre (n = 202), from 2019 till 2020, who had any of values beyond normal targets, for either of HbA1c, LDL-C, Ankle Brachial Index (ABI), Toe Brachial Index (TBI) or Albumin Creatinine Ratio (ACR). Percentage of patients achieving target values were classified as ATV (Achievers for the Target Value)

Results

Total of 202 patients (95 males, 107 females) were evaluated for glycemic and non – glycemic parameters (lipid profile, ABI, TBI, UACR). Mean age was 53 (± 13 years (95% CI 51 to 55). Mean duration of diabetes was 7.7 (± 6.5 minimum 1, maximum 36, 95% CI 6.8 to 8.6). The mean HbA1c was 8.5% (± 2 minimum 5.3, maximum 15, 95% CI 8.2 to 8.8). 4 patients reported macroalbuminuria (ACR > 300) and 49 patients had microalbuminuria (ACR 30–300). HbA1c and non glycemic measures as a marker for comprehensive diabetes care (table)

**Table 1** HbA1c and Non Glycemic Measures as a Marker for Comprehensive Diabetes Care
	Mean	± SD	95% CI	n (%) within target
HbA1c (< 7%)	8.7	2.1	8.3 to 9.1	54 (26.7)
LDL-C (target < 100 mg/dl) (n = 102)	73	18	69 to 76	102 (50.4)
ABI- Right (target 1–1.29)	1.2	0.07	1.2 to 1.2	146 (72.2)
ABI- Left (target 1–1.29)	1.2	0.08	1.2 to 1.2	141 (69.8)
TBI- Right (target 0.5–0.75)	0.65	0.066	0.62 to 0.68	25 (12.3)
TBI- Left (target 0.5–0.75)	0.63	0.077	0.60 to 0.67	22 (10.8)
Albumin Creatinine Ratio (ACR) (Normal < 30)	12	6.7	11 to 14	92 (45.5)

Discussion/Conclusion

Achievement of TBI (left side) was most compromised with just 10.8% of the patients demonstrating desired values, followed by TBI (right side) within normal values in 12.3% of patients and HbA1c of < 7 was not achieved by 73.3% of patients. Highest proportion of ATV were for the ABI value-right (72.2%). Results from our study provide indicators for formulation of patient outcome improvement plan. Evidence from our comprehensive care approach complements the clinical decision-making tool to allocate resources to intervene early to minimise the complications of diabetes and improve outcome

Endocrine Abstracts

AEP309