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21-12-2010 | Diabetes | Article

Factors associated with HbA1c target attainment in Type 2 diabetes clarified

Abstract

Free abstract

MedWire News: Study results show that ethnicity, duration of diabetes, baseline demographics, and ongoing pharmacotherapy, but not access to private drug insurance coverage, all influence glycated hemoglobin (HbA1c) target attainment in Type 2 diabetes.

The recommended target HbA1c in patients with Type 2 diabetes is 7.0% or below. Lawrence Leiter (University of Toronto, Ontario, Canada) and colleagues investigated factors influencing attainment of this target in 5280 Canadian patients with Type 2 diabetes and a HbA1c above 7.0%.

The patients were followed up for 12 months. Median HbA1c was 7.8% at baseline and 7.1% at 12 months. A significant 48% of the patients achieved a HbA1c target of 7.0% or below.

As reported in the journal Diabetes Care, the team found that patients who were older, of Asian or Black ethnicity, or who had a longer duration of diabetes were more likely to achieve the target HbA1c during the study.

Having a lower baseline HbA1c, body mass index, low-density lipoprotein cholesterol, and blood pressure also increased the chances of achieving the HbA1c target at study completion, as did taking angiotensin receptor blockers and a lower number of antihyperglycemic agents.

The researchers note, however, that having access to private compared with public insurance coverage of drug therapy did not significantly affect target accomplishment.

"In a large Canadian cohort of Type 2 diabetic patients not meeting glycemic targets, nearly 50% achieved the guideline-recommended HbA1c at or below 7.0% target after 12 months in a physician based practice optimization strategy," write the authors.

They conclude: "Patient demography, cardiometabolic health, and ongoing pharmacotherapy, but not access to private drug insurance coverage, contribute to the care gap in Type 2 diabetes."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Helen Albert