1547-P: Early Intensive Glycemic Control Is Responsible for Long-Term Durable Glycemic Control and Lower Rate of Diabetic Complications in Newly Diagnosed Type 2 Diabetes Patients: A Six-Year Observational Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1547-P
Author(s):  
NAM HOON KIM ◽  
SIN GON KIM ◽  
HYE-MIN JANG ◽  
KYOUNG JIN KIM ◽  
HYE SUK KIM
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Observational Study ◽  
Diabetic Complications ◽  
Newly Diagnosed ◽  
Intensive Glycemic Control ◽  
Diabetes Patients

scholarly journals Clinical Characteristics and Risk of Diabetic Complications in Data-Driven Clusters Among Type 2 Diabetes

2021 ◽  
Vol 12 ◽  
Author(s):  
Lin Xing ◽  
Fangyu Peng ◽  
Qian Liang ◽  
Xiaoshuang Dai ◽  
Junli Ren ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Complications ◽  
Clinical Characteristics ◽  
Chinese Patients ◽  
Newly Diagnosed ◽  
Medication Treatment ◽  
Dipeptidyl Peptidase 4 ◽  
Age Related

BackgroundThis study aimed to cluster newly diagnosed patients and patients with long-term diabetes and to explore the clinical characteristics, risk of diabetes complications, and medication treatment related to each cluster.Research Design and MethodsK-means clustering analysis was performed on 1,060 Chinese patients with type 2 diabetes based on five variables (HbA1c, age at diagnosis, BMI, HOMA2-IR, and HOMA2-B). The clinical features, risk of diabetic complications, and the utilization of elven types of medications agents related to each cluster were evaluated with the chi-square test and the Tukey–Kramer method.ResultsFour replicable clusters were identified, severe insulin-resistant diabetes (SIRD), severe insulin-deficient diabetes (SIDD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD). In terms of clinical characteristics, there were significant differences in blood pressure, renal function, and lipids among clusters. Furthermore, individuals in SIRD had the highest prevalence of stages 2 and 3 chronic kidney disease (CKD) (57%) and diabetic peripheral neuropathy (DPN) (67%), while individuals in SIDD had the highest risk of diabetic retinopathy (32%), albuminuria (31%) and lower extremity arterial disease (LEAD) (13%). Additionally, the difference in medication treatment of clusters were observed in metformin (p = 0.012), α-glucosidase inhibitor (AGI) (p = 0.006), dipeptidyl peptidase 4 inhibitor (DPP-4) (p = 0.017), glucagon-like peptide-1 (GLP-1) (p <0.001), insulin (p <0.001), and statins (p = 0.006).ConclusionsThe newly diagnosed patients and patients with long-term diabetes can be consistently clustered into featured clusters. Each cluster had significantly different patient characteristics, risk of diabetic complications, and medication treatment.

Optimal Allocation of Resources across Four Interventions for Type 2 Diabetes

2002 ◽  
Vol 22 (1_suppl) ◽  
pp. 80-91 ◽  
Author(s):  
Stephanie R. Earnshaw ◽  
Anke Richter ◽  
Stephen W. Sorensen ◽  
Thomas J. Hoerger ◽  
Katherine A. Hicks ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Smoking Cessation ◽  
Glycemic Control ◽  
Optimal Allocation ◽  
Newly Diagnosed ◽  
Allocation Of Resources ◽  
Cholesterol Reduction ◽  
Hypertension Control ◽  
Intensive Glycemic Control

Background Several interventions can be applied to prevent complications of type 2 diabetes. This article examines the optimal allocation of resources across 4 interventions to treat patients newly diagnosed with type 2 diabetes. The interventions are intensive glycemic control, intensified hypertension control, cholesterol reduction, and smoking cessation. Methods A linear programming model was designed to select sets of interventions to maximize quality-adjusted life years (QALYs), subject to varied budget and equity constraints. Results For no additional cost, approximately 211,000 QALYs can be gained over the lifetimes of all persons newly diagnosed with diabetes by implementing interventions rather than standard care. With increased availability of funds, additional health benefits can be gained but with diminishing marginal returns. The impact of equity constraints is extensive compared to the solution with the same intervention costs and no equity constraint. Under the conditions modeled, intensified hypertension control and smoking cessation interventions were provided most often, and intensive glycemic control and cholesterol reduction interventions were provided less often. Conclusions A resource allocation model identifies trade-offs involved when imposing budget and equity constraints on care for individuals with newly diagnosed diabetes.

scholarly journals Predictors of treatment failure during the first year in newly diagnosed type 2 diabetes patients: a retrospective, observational study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11005
Author(s):  
Hon-Ke Sia ◽  
Chew-Teng Kor ◽  
Shih-Te Tu ◽  
Pei-Yung Liao ◽  
Yu-Chia Chang
Keyword(s):  
Type 2 Diabetes ◽  
Medication Adherence ◽  
Glycemic Control ◽  
Treatment Failure ◽  
First Year ◽  
Regular Exercise ◽  
Newly Diagnosed ◽  
Baseline Hba1c ◽  
Diabetes Patients

Background Diabetes patients who fail to achieve early glycemic control may increase the future risk of complications and mortality. The aim of the study was to identify factors that predict treatment failure (TF) during the first year in adults with newly diagnosed type 2 diabetes mellitus (T2DM). Methods This retrospective cohort study conducted at a medical center in Taiwan enrolled 4,282 eligible patients with newly diagnosed T2DM between 2002 and 2017. Data were collected from electronic medical records. TF was defined as the HbA1c value >7% at the end of 1-year observation. A subgroup analysis of 2,392 patients with baseline HbA1c ≥8% was performed. Multivariable logistic regression analysis using backward elimination was applied to establish prediction models. Results Of all study participants, 1,439 (33.6%) were classified as TF during the first year. For every 1% increase in baseline HbA1c, the risk of TF was 1.17 (95% CI 1.15–1.20) times higher. Patients with baseline HbA1c ≥8% had a higher rate of TF than those with HbA1c <8% (42.0 vs 23.0%, p < 0.001). Medication adherence, self-monitoring of blood glucose (SMBG), regular exercise, gender (men), non-insulin treatment, and enrollment during 2010–2017 predicted a significant lower risk of TF in both of the primary and subgroup models. Conclusions Newly diagnosed diabetes patients with baseline HbA1c ≥8% did have a much higher rate of TF during the first year. Subgroup analysis for them highlights the important predictors of TF, including medication adherence, performing SMBG, regular exercise, and gender, in achieving glycemic control.

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