Treatment approach and HbA1c control among US adults with type 2 diabetes: NHANES 1999-2004.
OBJECTIVE: To examine the distribution of diabetic medications among adults with type 2 diabetes, and the association between glucose control and treatment approach in the US population. METHODS: Interview and prescription medication data from the 1999-2004 National Health and Nutrition Examination...
| Publicado en: | Current Medical Research & Opinion Vol. 25; no. 7; pp. 1605 - 1614 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Jul2009
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105432887&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105432887 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03007995 DFY jtl: Current Medical Research & Opinion issn: 03007995 maglogo: N pubinfo: dt: Jul2009 vid: 25 iid: 7 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 105432887 105432887 2010390903 10.1185/03007990902973300 NLM19469695 105432887 ppf: 1605 ppct: 9 formats: tig: atl: Treatment approach and HbA1c control among US adults with type 2 diabetes: NHANES 1999-2004. aug: au: Dodd AH Colby MS Boye KS Fahlman C Kim S Briefel RR affil: Mathematica Policy Research, Inc., Washington, DC 20024-2512, USA. adodd@mathematica-mpr.com sug: subj: Diabetes Mellitus, Type 2 Drug Therapy Diabetes Mellitus, Type 2 Prevention and Control Glycemic Control Administration, Oral Adult Aged American Diabetes Association Data Analysis Software Drug Therapy, Combination Female Funding Source Glycated Hemoglobin Blood Male Metformin Therapeutic Use Middle Age Practice Guidelines Sulfonylurea Compounds Therapeutic Use T-Tests Thiazolidinediones Therapeutic Use Treatment Outcomes Human Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: OBJECTIVE: To examine the distribution of diabetic medications among adults with type 2 diabetes, and the association between glucose control and treatment approach in the US population. METHODS: Interview and prescription medication data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were used to determine the treatment approach for US adults with type 2 diabetes. Mean glycosylated hemoglobin (HbA1c) and the proportion of adults meeting recommended guidelines for glucose control were estimated for each treatment approach. The most important study limitation was that participants were not asked what type of diabetes they had. Among adults with diabetes, a classification algorithm was used to identify those with type 2 diabetes. RESULTS: During 1999-2004, approximately 60% of adults with type 2 diabetes used oral agents only to manage their diabetes. The distribution of oral treatment therapies changed over time (p < 0.01); the most prevalent treatment shifted from sulfonylurea monotherapy in 1999-2000 (23.0%) to any oral agent regimen containing thiazolidinedione (TZD) in 2003-2004 (21.4%). Overall, only 52.2% of adults with type 2 diabetes met the American Diabetes Association (ADA) goal for HbA1c control (<7.0%) during 1999-2004. Across oral agent treatment categories, the proportion with HbA1c controlled at the 7.0 level was significantly lower (p < 0.01) for those on triple therapy (31.9%) (TZD, sulfonylurea, and metformin), than those on metformin alone (62.2%), likely reflecting a progressive treatment approach of prescribing additional medications for those with uncontrolled HbA1c levels. CONCLUSIONS: Use of multiple oral agents among adults with type 2 diabetes has increased (sulfonylurea and metformin, p = 0.03, triple therapy, p = 0.02). However, nearly half of adults with type 2 diabetes have HbA1c levels above ADA guidelines for control, indicating that available treatments could be used more optimally, and new diabetic agents may be needed. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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