Patterns of Care and Treatment Target Success among Persons with Type 2 Diabetes Mellitus in Dubai: A Retrospective Cohort Study

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• 作者：Katherine M. Osenenko ; BSc¹ ; Shelagh M. Szabo ; MSc¹ ; Lara Qatami ; MBA² ; Bonnie M. Korenblat Donato ; PhD³ ; Abdulrazzak Ali Al Madani ; MBChB⁴ ; Fatheya Fardallah Al Awadi ; MBBS⁴ ; Jaber Al-Ansari ; MD⁴ ; Ross Maclean ; MD⁵ ; Adrian R. Levy ; PhD⁶ ; ^{adrian.levy@dal.ca" class="auth_mail" title="E-mail the corresponding author}
• 关键词：diabetes ; glycemic control ; treatment ; United Arab Emirates
• 刊名：Value in Health Regional Issues
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：7
• 期：Complete
• 页码：87-93
• 全文大小：399 K

文摘

Despite the high prevalence of type 2 diabetes mellitus (T2DM), few data exist describing its management in Dubai. This study characterized the treatment and estimated levels of glycemic, lipid, and blood pressure control among a sample with T2DM at a large Dubai Hospital.

Methods

This retrospective cohort study systematically sampled charts from adults seeking care for T2DM from October 2009 to March 2010 until the target (N = 250) was reached. Data on patient characteristics, pharmacotherapy, complications, and laboratory testing were abstracted until September 2011. The frequency of treatments and modifications over the period was calculated, and measures of glycosylated hemoglobin A_1c, low-density lipoprotein, and blood pressure control were compared with guideline targets. Frequencies of complications were compared according to treatment type.

Results

One-third of the cohort comprised men, and the mean age was 58 years. At enrolment, the mean time from T2DM diagnosis was nearly 15 years and 74% had received insulin. During the study period, the most common regimens were insulin + oral combinations (55%) and oral combination therapy (39%). Overall, 67% received any insulin therapy during the study; and by study end, 78% had received insulin at any time. At the most recent assessment, guideline targets for glycosylated hemoglobin A_1c, blood pressure, and low-density lipoprotein were met by 23%, 29%, and 71%, respectively. Complications were more frequent among those treated with combination or insulin therapies.

Conclusions

This study provides baseline data from Dubai for future comparisons of the effectiveness of new treatments, and to better understand the humanistic and economic burden of T2DM and its complications.