Abstract
Introduction and aimTo evaluate the real-world clinical outcome of guideline-based treatment among adherent and committed type 2 diabetes mellitus (T2DM) patients.MethodsThe study reports the outcomes of an 11-year clinic-based standard care regime, based on the American Diabetes Association (ADA) guidelines and implemented in the authors’ practices. Records of 145 T2DM patients, who were regularly followed up, were reviewed. Descriptive and inferential statistical analysis was carried out with the Statistical Analysis System (SAS) (SAS Institute Inc., Cary, NC, USA) and with Statistical Package for Social Sciences (SPSS) (IBM Corp., Armonk, NY, USA), with Microsoft Word and Excel to generate graphs and tables.ResultsApart from a significant increase of body weight (but not of body mass index, BMI) and a significant decrease of diastolic blood pressure (DBP), there were insignificant changes in all major biochemical parameters, fasting plasma glucose (FPG), postprandial plasma glucose (PPG), glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C), creatinine, estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (ACR), over the 11 years of follow-up.ConclusionADA guideline-based management effectively maintained treatment goals among treatment adherent and committed T2DM patients over 11 years. Glycemic parameters (FPG, PPG, and HbA1c) and renal parameters (serum creatinine, eGFR, and ACR levels) remained stable. Our outcomes data were better than those recorded in the landmark United Kingdom Prospective Diabetes Study (UKPDS) and Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE).
Highlights
Introduction and aimTo evaluate the real-world clinical outcome of guideline-based treatment among adherent and committed type 2 diabetes mellitus (T2DM) patients
The study reports the outcomes of an 11-year clinic-based standard care regime, based on the American Diabetes Association (ADA) guidelines and implemented in the authors’ practices
The landmark United Kingdom Prospective Diabetes Study (UKPDS) had shown that improvement in blood glucose control reduced the risk of diabetesrelated complications and multiple interventions need to be initiated early to prevent the development of complications in persons with diabetes [2]
Summary
To evaluate the real-world clinical outcome of guideline-based treatment among adherent and committed type 2 diabetes mellitus (T2DM) patients. The landmark United Kingdom Prospective Diabetes Study (UKPDS) had shown that improvement in blood glucose control reduced the risk of diabetesrelated complications and multiple interventions need to be initiated early to prevent the development of complications in persons with diabetes [2]. Post-UKPDS, the management of type 2 diabetes mellitus (T2DM) conventionally followed a stepwise approach. Management commences with lifestyle intervention, followed by the addition of a single oral anti-diabetic drug, usually metformin, a combination of oral drugs and eventually insulin. There is a small subset of patients who are regular in their follow-up and diligent in their adherence to the treatment guidelines. We have retrospectively evaluated the outcome of the guideline-based treatment protocol in our adherent patients over 11-year period of follow-up
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