| アブストラクト | AIMS/HYPOTHESIS: The aim of this work was to study levels of HbA1c and patterns of adjusting glucose-lowering drugs in patients with impaired glycaemic control over 10 years after diagnosis of type 2 diabetes. METHODS: We studied 4,529 individuals in The Health Improvement Network Database newly diagnosed with type 2 diabetes in the year 2000. RESULTS: From 6 months to 10 years after diagnosis, the HbA1c increased from 7.04% (53.4 mmol/mol) to 7.49% (58.3 mmol/mol) (average annual change: 0.047% [0.51 mmol/mol]). The greatest annual change occurred between 6 months and 2 years (0.21% [2.30 mmol/mol] increase per year, p < 0.001), followed by the 2-5 year time period (0.033% [0.36 mmol/mol] increase per year, p < 0.001). No significant increase in HbA1c occurred between 5 and 10 years (p = 0.20). In multivariable analyses, patients who were younger (p < 0.001), with higher BMI (p = 0.033) and who were current insulin users (p = 0.024) at diagnosis had greater increases in HbA1c between 6 months and 2 years. For individuals with HbA1c above 7.0% (53 mmol/mol) the mean time to next measurement of HbA1c was 0.53 years and increase in doses or changes to other glucose-lowering medications were performed in 26% of cases. CONCLUSIONS/INTERPRETATION: HbA1c increases by approximately 0.5% (5 mmol/mol) over 10 years after diagnosis of type 2 diabetes, with the main increase appearing in the first years after diagnosis. More frequent monitoring of HbA1c and adjustments of glucose-lowering drugs may be essential to prevent the decline. |
| ジャーナル名 | Diabetologia |
| Pubmed追加日 | 2014/5/9 |
| 投稿者 | Lind, Marcus; Pivodic, Aldina; Cea-Soriano, Lucia; Nerman, Olle; Pehrsson, Nils-Gunnar; Garcia-Rodriguez, Luis A |
| 組織名 | Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,;Sweden, lind.marcus@telia.com. |
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/24811709/ |