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Patient‐level predictors of achieving early glycaemic control in Type 2 diabetes mellitus: a population‐based study
Author(s) -
Svensson E.,
Baggesen L. M.,
Thomsen R. W.,
Lyngaa T.,
Pedersen L.,
Nørrelund H.,
Buhl E. S.,
Haase C. L.,
Johnsen S. P.
Publication year - 2016
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13184
Subject(s) - medicine , poisson regression , medical prescription , diabetes mellitus , type 2 diabetes mellitus , population , cohort , type 2 diabetes , comorbidity , endocrinology , environmental health , pharmacology
Aims To identify individual predictors of early glycaemic control in people with Type 2 diabetes mellitus after initiation of first glucose‐lowering drug treatment in everyday clinical practice. Methods Using medical registries, we identified a population‐based cohort of people with a first‐time glucose‐lowering drug prescription in Northern Denmark in the period 2000–2012. We used Poisson regression analysis to examine patient‐level predictors of success in reaching early glycaemic control [HbA 1c target of < 53 mmol/mol (7%)] < 6 months after treatment start. Results Among the 38 418 people (median age 63 years), 27 545 (72%) achieved early glycaemic control. The strongest predictor of achieving early control was pre‐treatment HbA 1c level; compared with a pre‐treatment HbA 1c level of ≤ 58 mmol/mol (7.5%), the adjusted relative risks of attaining early control were 0.63 (95% CI 0.61–0.64) for baseline HbA 1c levels of > 58 and ≤ 75 mmol/mol (> 7.5 and ≤ 9%), and 0.58 (95% CI 0.57–0.59) for a baseline HbA 1c level of > 9% (> 75 mmol/mol). All other examined predictors were only weakly associated with the chance of achieving early control. After adjustment, the only characteristics that remained independently associated with early control (in addition to high baseline HbA 1c ) were being widowed (adjusted relative risk 0.95; 95% CI 0.93–0.97) and having a high Charlson comorbidity index score (score ≥ 3; adjusted relative risk 0.94; 95% CI 0.90–0.97). Conclusions In a real‐world clinical setting, people with Type 2 diabetes mellitus initiating glucose‐lowering medication had a similar likelihood of achieving glycaemic control, regardless of sex, age, comorbidities and other individual factors; the only strong and potentially modifiable predictor was HbA 1c before therapy start.