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Glucose-lowering treatment and clinical results in 163 121 patients with type 2 diabetes: an observational study from the Swedish national diabetes register
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2012 (English)In: Diabetes, obesity and metabolism, ISSN 1462-8902, E-ISSN 1463-1326, Vol. 14, no 8, 717-726 p.Article in journal (Refereed) Published
Abstract [en]

Aims: To analyse clinical characteristics and treatment results in unselected type 2 diabetes mellitus (T2DM) patients, with non-pharmacological treatment as well as the most commonly used pharmacological glucose-lowering treatment regimens, in everyday clinical practice. Methods: In this population-based cross-sectional study, information was linked from the Swedish National Diabetes Register, Prescribed Drug Register and Patient Register. T2DM patients with non-pharmacological treatment and T2DM patients continuously using the 12 most common pharmacological treatment regimens were included in the study (n = 163121). Results: There were statistically significant differences in clinical characteristics between the groups. Patients with insulin-based treatment regimens had the longest duration of diabetes and more cardiovascular risk factors than the T2DM-population in general. The proportion of patients reaching HbA1c =7% varied between 70.1% (metformin) and 25.0% [premixed insulin (PMI) + SU) in patients with pharmacological treatment. 84.8% of the patients with non-pharmacological treatment reached target. Compared to patients on metformin, patients on other pharmacological treatments had a lower likelihood, with hazard ratios ranging from 0.58; 95% confidence interval (CI), 0.540.63 to 0.97;0.940.99, of having HbA1c =7% (adjusted for covariates). Patients on insulin-based treatments had the lowest likelihood, while non-pharmacological treatment was associated with an increased likelihood of having HbA1c =7%. Conclusion: This nation-wide study shows insufficiently reached treatment goals for haemoglobin A1c (HbA1c) in all treatment groups. Patients on insulin-based treatment regimens had the longest duration of diabetes, more cardiovascular risk factors and the highest proportions of patients not reaching HbA1c target.

Place, publisher, year, edition, pages
2012. Vol. 14, no 8, 717-726 p.
Keyword [en]
antihyperglycaemic agents, insulin, pharmacoepidemiology, therapeutic guidelines, therapy, type 2 diabetes
National Category
Endocrinology and Diabetes
URN: urn:nbn:se:uu:diva-177843DOI: 10.1111/j.1463-1326.2012.01591.xISI: 000305892000005PubMedID: 22364580OAI: oai:DiVA.org:uu-177843DiVA: diva2:541612
Available from: 2012-07-20 Created: 2012-07-19 Last updated: 2013-01-09Bibliographically approved

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Cederholm, JanZethelius, Björn
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Family Medicine and Preventive MedicineGeriatrics
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