Search for clinical predictors of good glycemic control in patients starting or intensifying oral hypoglycemic pharmacological therapy: A multicenter prospective cohort study

J Diabetes Complications. 2020 Feb;34(2):107464. doi: 10.1016/j.jdiacomp.2019.107464. Epub 2019 Oct 20.

Abstract

Aims: Our aim was to search for clinical predictors of good glycemic control in patients starting or intensifying oral hypoglycemic pharmacological therapy.

Methods: A multicenter, prospective cohort of 499 diabetic subjects was enrolled in this study: patients with newly diagnosed diabetes (NDM group) or poor glycemic control with oral antidiabetic drugs (OADs) (PDM group). All subjects then started or intensified OADs therapy and followed up for 91 days. Glycemic control was determined according to HbA1c at day 91 with HbA1c <7% considered good.

Results: The proportions of patients with good glycemic control after follow up for 91 days were 66.9% and 34.8% in NDM group and PDM group respectively. Logistic regression analysis showed that the change in GA at 28 days was the only predictor of good glycemic control in NDM patients (OR = 1.630, 95% CI 1.300-2.044, P < 0.001). In PDM patients, changes in GA at 28 days, CPI, baseline HbA1c, diabetic duration, and BMI were all independent predictors of good glycemic control (All P < 0.05).

Conclusions: GA decline is a good predictor of future success in newly diagnosed patients. In patients intensifying therapy, beside GA decline, other individualized clinical characteristics should also be considered.

Keywords: Oral antidiabetic drugs; Predictor; Type 2 diabetes.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Administration, Oral
  • Adult
  • Biomarkers / blood
  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy
  • Female
  • Glycated Hemoglobin / analysis
  • Glycated Serum Albumin
  • Glycation End Products, Advanced
  • Glycemic Control*
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / diagnosis
  • Hyperglycemia / drug therapy
  • Hypoglycemic Agents / therapeutic use*
  • Male
  • Middle Aged
  • Prospective Studies
  • Serum Albumin / analysis*
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Glycation End Products, Advanced
  • Hypoglycemic Agents
  • Serum Albumin
  • Glycated Serum Albumin