Malinda S. Tan , Kibum Kim , Cody J. Olsen , Diana I. Brixner
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引用次数: 0
Abstract
Aims
Treatment intensification (TI) may help patients with type 2 diabetes mellitus (T2DM) achieve target hemoglobin A1c (A1c) < 7.0%. This study aimed to measure the influence of TI on A1c outcome in patients who insufficiently responded to two classes of oral antidiabetic drugs (2OADs).
Materials and methods
A retrospective observational study of patients with T2DM was performed using health plan claims and A1c records accrued between January 2010 and March 2017. The study population had an A1c ≥ 7.0% (baseline A1c) after treatment with 2OADs for one year. Patients who had TI with a third-class antidiabetic agent, including basal/biphasic insulin, glucagon-like peptide-1 receptor agonists (GLP-1RA), or OAD, within 365 days after baseline A1c were included. Patients who did not receive TI (NTI) within one year from the suboptimal A1c control were matched with TI patients using a propensity score approach. The odds ratio of achieving an A1c < 9.0% and < 7.0% for TI vs. NTI were calculated by logistic regressions.
Results
A1c values of 401 TI − NTI matched pairs were analyzed. TI patients achieved a significantly lower follow-up A1c than NTI patients (7.79% ± 1.45 vs. 8.02% ± 1.67, p = 0.03). The odds ratio [95% confidence interval] of achieving A1c < 9.0% and < 7.0% for TI was 1.50 [1.04−2.17] and 1.19 [0.87−1.63], respectively.
Conclusion
TI with a third-class agent further reduced A1c levels in patients whose A1c insufficiently responded with 2OADs; however, most patients failed to achieve an A1c < 7.0% on the intensified treatment.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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