3 years ago

Prevalence of hypoglycemia among a sample of sulfonylurea-treated patients with Type 2 diabetes mellitus in Argentina: The real-life effectiveness and care patterns of diabetes management (RECAP-DM) study

Claudio Gonzalez, Cyntia Monti, Adolfo Pinzon, Homero Monsanto, Flavia Ejzykowicz, Argentinean Recap Group

Publication date: Available online 31 July 2018

Source: Endocrinología, Diabetes y Nutrición

Author(s): Claudio Gonzalez, Cyntia Monti, Adolfo Pinzon, Homero Monsanto, Flavia Ejzykowicz, Argentinean Recap Group

Abstract
Aim

Strict blood glucose control in the treatment of diabetes can sometimes lead to hypoglycemia. The main aim of this study was to assess the prevalence of hypoglycemia among patients receiving sulfonylureas alone, or in combination with metformin, for the treatment of Type 2 Diabetes Mellitus (T2DM) in Argentina.

Methods

This is a real life, multi-center, retrospective, and cross-sectional study based on clinical chart reviews including cross-sectional data, and evaluation of patient questionnaires of T2DM patients (>30 years), treated with sulfonylureas alone or in combination with metformin, during a routine clinic visit in 16 medical centers across Argentina. Socio-demographic and clinical parameters were collected from medical records, as well as hypoglycemic events from both the medical records and the patient questionnaires. The glycated hemoglobin (HbA1c) levels were obtained from medical records as well as a blood test.

Results

The study included a total of 397 patients with a mean age of 62.5 years, diagnosed for 9.9 years, and 54.2% male. Mean HbA1c levels were 8.1%, (65 mmol/mol) at enrolment, with 36.4% being in control (HbA1c < 7%, (53 mmol/mol). Patients with HbA1c < 7%, (53 mmol/mol) were significantly older, diagnosed at older age, and had lower triglyceride levels. Almost 50% reported hypoglycemic episodes that were mostly mild, and with women more likely to report them. The large majority (86%) were on combined metformin and sulfonylureas, most commonly Glibenclamide (48.6%). Patients on combined therapy were significantly younger and more likely to have uncontrolled diabetes.

Conclusions

This study demonstrated that out of a sample of 397 patients with T2DM treated with sulfonylureas alone or in combination with metformin in Argentina, around 50% of them reported symptoms of hypoglycemia induced by sulfonylureas, and one third of them achieved target HbA1c < 7% levels.

Resumen
Objetivo

El control estricto de la glucemia en el tratamiento de la diabetes puede provocar hipoglucemia. El objetivo principal de este estudio fue evaluar la prevalencia de hipoglucemia en pacientes que reciben sulfonilureas (SU) solas o en combinación con metformina para el tratamiento de la diabetes tipo 2 en Argentina.

Métodos

Este es un estudio multicéntrico, retrospectivo y transversal de la vida real basado en la revisión de historias clínicas que incluyen datos transversales y evaluación de cuestionarios de pacientes con diabetes mellitus tipo 2 (>30 años) tratados con SU solas o en combinación con metformina, durante una consulta de rutina en 16 centros médicos en toda Argentina. Se recogieron los parámetros sociodemográficos y clínicos de los registros médicos y los eventos hipoglucémicos de los registros médicos y los cuestionarios de los pacientes. Los niveles de hemoglobina glucosilada (HbA1c) se obtuvieron a partir de registros médicos y un análisis de sangre.

Resultados

Se incluyeron 397 pacientes. La edad media fue de 62,5 años, con diagnóstico realizado hace 9,9 años y donde el 54,2% de los pacientes fueron varones. Los niveles de HbA1c fueron del 8,1% (65 mmol/mol) al momento del enrolamiento y del 36,4% estaban en meta terapéutica (HbA1c < 7%, 53 mmol/mol). Dichos pacientes tenían una edad avanzada y los niveles de triglicéridos más bajos. Cerca del 50% informó de episodios de hipoglucemia, en su mayoría leves, y las mujeres eran más propensas a informar dichos episodios. El 86% estaban con metformina combinada con SU, más comúnmente glibenclamida (48,6%). Dichos pacientes eran significativamente más jóvenes y más propensos a tener diabetes no controlada.

Conclusiones

Este estudio demostró que de una muestra de 397 pacientes con diabetes mellitus tipo 2 tratados con SU solas o en combinación con metformina en Argentina, alrededor del 50% de ellos informaron síntomas de hipoglucemia inducida por SU y un tercio de ellos alcanzaron el objetivo HbA1c < 7%.

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