scholarly journals Prevalence of Hypoglycemia, Treatment Satisfaction, Adherence and Their Associations with Glycemic Goals in Patients with Type 2 Diabetes Mellitus Treated with Sulfonylureas: Findings from the Real-Life Effectiveness and Care Patterns of Diabetes Management (RECAP-DM) in Romania

2019 ◽  
Vol 26 (1) ◽  
pp. 55-64
Author(s):  
Simona Popoviciu ◽  
Anca Alionescu ◽  
Irma Sisic
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Diabetes Management ◽  
Real Life ◽  
Haemoglobin A1c ◽  
The Mean ◽  
The Impact

Abstract Background and aims: The aim of this study was to assess the prevalence and evaluate the impact on several treatment and quality of life parameters of hypoglycemia in type 2 diabetes mellitus patients treated with sulfonylureas (SU) in Romania. Secondary objective was to determine the proportion of patients attaining haemoglobin A1c (HbA1c) target of <7%. Material and method: This was a multi-center, observational study using retrospective clinical chart and laboratory parameters review, and a cross-sectional survey in Romania. The sample in this study consisted of 385 patients. Socio-demographic and clinical variables were compared between patients with inadequate and adequate control. Results: The mean age of all enrolled subjects was 65.37 (33-87) years. The average BMI was 30.44 kg/m2. Mean diabetes duration was 7.76 (6 months -32) years with the mean age of diabetes at diagnosis of 57.75 (31-85) years. HbA1c was recorded for 238 subjects with mean value of 7.12 (4.8-10.97) %. Conclusions: The prevalence of hypoglycaemia in SU treated patients was 42.2%. Highest prevalence was in the 50-60 age category, at 49.2% and lowest among the eldest subjects (>70 years), at 38.6%. Prevalence of patients at the goal of HbA1c<7% was 50.8 %. Patients with adequate glycaemic control had more acceptable BMI than those with inadequate glycaemic control. In patients not achieving a goal of HbA1c < 7%, higher level of plasma glucose and total cholesterol was determined compared to those with adequate glycaemic control. There were no significant differences in the HDL-C, triglycerides or albumin:creatinine ratios in patients with both adequate and inadequate glycaemic control.

scholarly journals Impact of an Advanced Practice Pharmacist Type 2 Diabetes Management Program: A Pilot Study

2019 ◽  
Vol 10 (4) ◽  
pp. 20
Author(s):  
Jelena Lewis ◽  
Tiffany Nguyen ◽  
Hana Althobaiti ◽  
Mona Alsheikh ◽  
Brad Borsari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Management ◽  
Drug Dose ◽  
Advanced Practice ◽  
Dose Increase ◽  
Therapeutic Decisions ◽  
The Impact

Background: The purpose of this study was to describe the impact of an Advanced Practice Pharmacist (APh) on lowering hemoglobin A1c (HbA1c) in patients with type 2 diabetes within a patient centered medical home (PCMH) and to classify the types of therapeutic decisions made by the APh. Methods: This was a retrospective study using data from electronic health records. The study evaluated a partnership between Chapman University School of Pharmacy and Providence St. Joseph Heritage Healthcare that provided diabetes management by an Advanced Practice Pharmacist in a PCMH under a collaborative practice agreement. Change in the HbA1c was the primary endpoint assessed in this study. The type of therapeutic decisions made by the APh were also evaluated. Descriptive analysis and Wilcoxon signed rank test were used to analyze data. Results: The study included 35 patients with diagnosis of type 2 diabetes mellitus managed by an APh from May 2017 to December 2017. Most of the patients were 60-79 years old (68.5%), 45.7% were female, and 45.7% were of Hispanic/Latino ethnicity. The average HbA1c was 8.8%±1.4% (range=6.0%-12.4%) and 7.5%±1.4% (range=5.5%-12.4%) at the initial and final APh visit, respectively (p<0.0001). Therapeutic decisions made by the APh included drug dose increase (35.5% of visits), drug added (16.4%), drug dose decrease (6.4%), drug switch (5.5%), and drug discontinuation (1.8%). Conclusion: The Advanced Practice Pharmacist’s interventions had a significant positive impact on lowering HbA1c in patients with type 2 diabetes mellitus in a PCMH. The most common therapeutic decisions made by the APh included drug dose increase and adding a new drug.   Article Type: Pharmacy Practice

scholarly journals Clinical characteristics and determinants of glycaemic control among type 2 diabetes mellitus (T2DM) patients in Fiji

2020 ◽  
Author(s):  
Pablo Romakin ◽  
Donald Wilson ◽  
Sabiha Khan ◽  
Masoud Mohaammadnezhad
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Blood Sugar ◽  
Diabetes Management ◽  
Control Level ◽  
Poor Glycaemic Control ◽  
Care Workers

Abstract Background Diabetes is a global health problem reaching pandemic proportions. In Fiji, diabetes has a prevalence rate of 15.6% in 2011which is estimated to rise to 19.3% in 2020. The aim of this study was to determine the proportion of poor glycaemic control level and its determinants among type 2 diabetes mellitus (T2DM) patients. Methods This retrospective study was conducted in three selected health centres in Suva, Fiji with the following inclusion criteria: adult T2DM ≥ 18 years old registered during 2011 to 2016; on treatment for > 1year; had > 4 clinic visits and; had a recent HbA1c result in 2017. Logistic regression analysis was performed and p < 0.05 considered as significant. Results There were 200 female (59.2%) and 138 male (40.8%) T2DM patients in this study with a mean age of 56.5 years (SD = ± 9.9). Most of T2DM patients have poorly controlled random blood sugar (RBS), 67.1% and fasting blood sugar (FBS), 63.0%. Two-thirds (65.4%) had associated medical conditions. The proportion of poor glycaemic control (HbA1c < 7%) was 77.2%. Mean HbA1c was 8.6% (± 2.04). RBS, FBS, cholesterol, estimated glomerular filtration rate (eGFR) and diastolic blood pressure (DBP) were significant (p < 0.05) determinants of poor glycaemic control. Conclusions Health care workers dealing with T2DM patients should consider the clinical determinants of poor glycaemic control for a more effective diabetes management.

scholarly journals Clinical characteristics and determinants of glycaemic control among type 2 diabetes mellitus (T2DM) patients in Fiji

2021 ◽  
Author(s):  
Pablo Romakin ◽  
Donald Wilson ◽  
Sabiha Khan ◽  
Masoud Mohaammadnezhad
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Glycaemic Control ◽  
Blood Sugar ◽  
Diabetes Management ◽  
Control Level ◽  
Poor Glycaemic Control

Abstract Background: Glycemic control is the centre in diabetes management. In patients with type 2 diabetes mellitus (T2DM), glycemic control is associated with clinical determinants. The aim of this study was to determine the proportion of poor glycemic control level and its clinical determinants among T2DM patients.Methods: This retrospective cross-sectional study was conducted on the medical records of T2DM patients attending diabetes clinics at the three selected health centres in Suva, Fiji. Patients who met the following criteria were included in the study: adult T2DM >18 years old registered during 2011 to 2016; on treatment for >1year; had >4 clinic visits and; had a recent HbA1c result in 2017. Logistic regression analysis was performed. A p value of <0.05 was considered as significant.Results: There were 200 female (59.2%) and 138 male (40.8%) T2DM patients included in this study with a mean age of 56.5 years (SD = + 9.9). Majority have poorly controlled random blood sugar (RBS), 67.1% and fasting blood sugar (FBS), 63.0%. Two-thirds (65.4%) had co-morbidities. The proportion of poor glycaemic control (HbA1c <7%) was 77.2% with mean HbA1c of 8.6% (+ 2.04). RBS, FBS, cholesterol, estimated glomerular filtration rate (eGFR) and diastolic blood pressure (DBP) were significant (p<0.05) determinants of poor glycaemic control.Conclusions: This study identified clinical determinants of T2DM patients that are highly associated with glycemic control. Health care workers managing T2DM patients should address these clinical determinants in order to achieve glycemic control.

scholarly journals Effectiveness, Safety and Tolerability of Vildagliptin with or without Metformin in Bangladeshi Patients with Type 2 Diabetes Mellitus: Results from Real-Life Observational Study

2016 ◽  
Vol 6 (1) ◽  
pp. 12-17
Author(s):  
Zafar Ahmed Latif ◽  
Md Faruque Pathan ◽  
Md Farid Uddin ◽  
MA Hasanat ◽  
SM Ashrafuzzaman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Real Life ◽  
Combination Group ◽  
Final Visit ◽  
Single Pill ◽  
The Mean ◽  
Multi Center Study

Background: Type 2 diabetes mellitus (T2DM) is a progressive disease which needs prolonged management with anti-diabetic drugs. The purpose of the present study was to assess effectiveness, safety and tolerability of treatment by vildagliptin alone or with the combination of vildagliptin and metformin in T2DM patients in a real-world setting.Methods: This non-interventional, prospective, multi-center study was conducted in several hospitals in Bangladesh from 15th September 2010 to 12th June 2012. Both male and female patients, aged ?18 years with an established diagnosis of T2DM, who had been prescribed vildagliptin or vildagliptin added to metformin free-dose or single-pill combination according to local prescribing information and who consented to data collection, were eligible for inclusion in the study. During the observational period of 24±6 weeks, data from three routine clinic visits were recorded; i.e. the baseline visit (Day 1), visit 2 (week 12±4 weeks) and a final visit (visit 3) at the end of the study (week 24±6 weeks).Result: A total number of 510 patients were enrolled in this study of which 468 patients were analyzed for the study and the remaining 42 patients were lost to follow up. Patients in vildagliptin group were treated with vildagliptin as monotherapy which was received by 101 patients; however, patients in vildagliptin/metformin group received the combination of vildagliptin and metformin which was in 367 cases. In vildagliptin group, the mean HbA1c was reduced from baseline (8.50±1.02 %) to 24 week (7.19±0.74%) (p<0.0001). Similarly, in vildagliptin group the mean HbA1c at week 12 (7.76±0.96 %) was lower vs. baseline (8.50±1.02 %) (p<0.0001). In vildagliptin and metformin combination group, the mean HbA1c at week 24 (7.02±0.66%) was lower vs. baseline (8.55±0.75%) (p<0.0001). There were no deaths and no serious adverse effects. None of the patients reported any hypoglycemic event.Conclusion: In conclusion vildagliptin treating T2DM patients with or without metformin is associated with a significant and clinically relevant improvement in glycaemic control. Furthermore, vildagliptin treatment is generally well toleratedBirdem Med J 2016; 6(1): 12-17

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