What are the factors associated with long-term glycaemic control in patients with type 2 diabetes and elevated HbA1c (≥7.0%) at initiation of second-line therapy? Results from the DISCOVER study - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Diabetes, Obesity and Metabolism Année : 2021

What are the factors associated with long-term glycaemic control in patients with type 2 diabetes and elevated HbA1c (≥7.0%) at initiation of second-line therapy? Results from the DISCOVER study

Résumé

AIMS: Glycaemic control is a cornerstone of type 2 diabetes (T2D) management. We assessed factors associated with good long-term glycaemic control in patients with glycated haemoglobin (HbA1c) ≥7.0% at initiation of second-line glucose-lowering therapy, using data from DISCOVER, a global, prospective, 3-year observational study of patients with T2D. MATERIALS AND METHODS: This analysis included patients with HbA1c ≥7.0% at baseline (initiation of second-line therapy). Multivariable regression models assessed factors associated with having HbA1c <7.0% at 3 years in 3 years in two distinct groups: patients with (1) HbA(1c) ≥7.0% and <9.0% and (2) HbA(1c) ≥9.0% at baseline. RESULTS: In total, 7575 patients with baseline HbA1c ≥7.0% were included (2233 with baseline HbA1c ≥9.0%). At 6 months, 43.7% and 24.2% of patients had an HbA(1c) level < 7.0% in group 1 and 2, respectively; the corresponding proportions at 3 years were 45.8% and 29.3%. Having HbA1c <7.0% at 6 months (vs. ≥7.0%) was the strongest predictor of having HbA1c <7.0% at 3 years in both group 1 and 2 (odds ratio [95% confidence interval]: 2.01 [1.77-2.27] and 2.68 [2.10-3.41], respectively). Longer T2D duration was associated with a decreased likelihood of having HbA1c <7.0% at 3 years. CONCLUSIONS: In patients with poor glycaemic control at initiation of second-line therapy, early attainment of HbA1c <7.0% appears predictive of long-term glycaemic control, suggesting that timely modification of treatment strategies in patients with elevated HbA1c after 6 months is important to minimize therapeutic inertia. This article is protected by copyright. All rights reserved.
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hal-03285373 , version 1 (13-07-2021)

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Fabrice Bonnet, Hungta Chen, Andrew Cooper, Marίlia B Gomes, Linong Ji, et al.. What are the factors associated with long-term glycaemic control in patients with type 2 diabetes and elevated HbA1c (≥7.0%) at initiation of second-line therapy? Results from the DISCOVER study. Diabetes, Obesity and Metabolism, 2021, ⟨10.1111/dom.14476⟩. ⟨hal-03285373⟩
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