• 作者：Antonio Pé ; rez^a ; ^b ; ^{aperez@santpau.cat} ; Josep Franch^c ; Aleix Cases^d ; José ; Ram&#243 ; n Gonzá ; lez Juanatey^e ; Pedro Conthe^f ; Eva Gimeno^g ; Arantxa Matali^h
• 关键词：Diabetes tipo 2 ; Control glucé ; mico ; Tiempo de evolució ; n ; Antidiabé ; ticos orales ; Insulinoterapia ; Atenció ; n primaria ; Atenció ; n especializada
• 刊名：Medicina Cl¡§anica
• 出版年：2012
• 出版时间：5 May, 2012
• 年：2012
• 卷：138
• 期：12
• 页码：505-511
• 全文大小：346 K

Background and objective

To evaluate the relationship between the degree of glycemic control and the features of the disease and glucose-lowering treatment in patients with type 2 diabetes mellitus in Spain.

Patients and methods

Cross-sectional epidemiological study in Spain with consecutive sampling. We recorded demographic and clinical variables of patients who were followed up in the center for > 12 months.

Results

We analyzed data from 6,801 patients enrolled by 734 specialist and 965 primary care physicians: 97.8 % received pharmacological treatment (30.3 % monotherapy, 51,4 % dual therapy, 16.1 % triple therapy and 26.6 % insulin). HbA_1c was 7.3 (1.2) % and 40.4 % of patients had HbA_1c < 7.0 % . This proportion varied (P < .0001) according to the duration of diabetes (51.8 % with < 5 years, 39.6 % with 5-10 years, 35.1 % with 10-15 years and 31 4 %  > 15 years) and the type of treatment (52.9 % monotherapy, 35.6 % dual therapy, 28.0 % triple therapy and 25.2 % insulin). In the multivariate analysis, insulin therapy (odds ratio [OR] 0.329; IC_{95 %} 0,267-0,405) and the presence of components of metabolic syndrome (hypertriglyceridemia and/or low HDL and/or abdominal obesity (OR 0.728; IC_{95 %} 0,595-0,890) were associated with poor glycemic control.

Conclusions

We observed an impairment of glycemic control with the progression of the disease and the complexity of the process and treatment, which in part may be related to the inadequate treatment selection and intensification.