The relationship of early individual glycemic control strategy and reaching standard in newly diagnosed type 2 diabetes

Abstract

Objective To analyze the early therapy strategy on glucose control in type 2 diabetic patients. Methods From June 2002 to May 2003, the medication and blood glucose control in 1396 cases with type 2 diabetes in national 10 grade 3A hospitals were retrospectively analyzed. The patients were diagnosed newly or within one year in CDCPS (Chinese Diabetes Complication Prevention Study), with(51±9)yrs, body mass index(BMI) (24.9±3.0)kg/m2. Besides the same instruction of lifestyle intervention, the patients were further divided as four groups: without intervention(group A), single oral hypoglycemic agent(group B), combined oral hypoglycemic agents(group C) and treatment including insulin(group D). The χ2 test and analysis of covariance was used for count data and measurement data between groups. The paired t test was used comparison before and after the intervention. Pearson correlation analysis was used for factors affecting the efficacy of glucose analysis. Results (1)The level of HbA1c at baseline was (7.3±1.9)%, and the fasting blood-glucose(FBG) was(7.5±2.4)mmol/L among the four intervention group before the treatment adjusted. After 20 months of follow-up, the mean FBG and HbA1c reached to (6.7±1.6) mmol/L and (6.1±1.4) %, respectively. (2) For patients with HbA1c>7%, sulfonylurea and (or) biguanide monotherapy or combination therapy in this study was the most frequently chosen treatment. Compliance rates of HbA1c were 79.2%, 81.9%, respectively. The difference was not statistically significant. (3) HbA1c levels at the end of the follow-up and the patient's age (r=0.087, P 0.05). Conclusion According to the levels of glucose and HbA1c, the early individualized therapy strategy mainly based on sulphanylureas and/or biguanides is proved to be persistently effective and safe in newly diagnosed type 2 diabetic patients. More positive treatment should be recommended to the patients with higher HbA1c level. Key words: Diabetes mellitus, type 2; Hemoglobin A, glycosylated; Therapy strategy