Ontology type: schema:ScholarlyArticle Open Access: True
2017-02
AUTHORSNicolle Müller, Kamlesh Khunti, Oliver Kuss, Ulf Lindblad, John J. Nolan, Guy EHM Rutten, Marina Trento, Massimo Porta, Johannes Roth, Guillaume Charpentier, Viktor Jörgens, Ulrich A. Müller
ABSTRACTAIMS: We used data from the GUIDANCE Study to determine the care of people with type 2 diabetes according to age and accompanying cardiovascular diseases and to assess indicators of overtreatment of glycaemia. METHODS: The GUIDANCE study was a retrospective, cross-sectional study from 2009-2010 based on the records of 7597 people in France, Belgium, Italy, the Netherlands, Sweden, UK, Ireland and Germany. We analysed the level of metabolic control achieved and blood glucose-lowering medication used in different age groups and in relation to accompanying diseases. RESULTS: 4.459 patients (59.1%) were 65 years or older. Their HbA1c levels were similar to those with <65 years. 44.7% of patients ≥65 years had an HbA1c ≤7% (53 mmol/mol) and were treated with insulin or sulfonylureas, and 27.1% of them had ischaemic heart disease or congestive heart failure. Significantly more patients with heart disease had HbA1c values ≤7% (53 mmol/mol) and were treated more often with insulin or sulfonylureas compared to patients of the same age without heart disease. CONCLUSIONS: Most patients were treated according to guidelines valid at the time this large international patient sample was surveyed. Older and younger patients were at a similar level of metabolic control, and almost half of the patients with an age of ≥65 years and treated with insulin or sulfonylurea had HbA1c levels below the target range (≤7%) for younger patients. However, these patients have an increased risk of severe hypoglycaemic events with potentially dangerous complications, particularly in those with cardiovascular diseases. More... »
PAGES209-214
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DOIhttp://dx.doi.org/10.1007/s00592-016-0939-9
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PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/27837286
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"description": "AIMS: We used data from the GUIDANCE Study to determine the care of people with type 2 diabetes according to age and accompanying cardiovascular diseases and to assess indicators of overtreatment of glycaemia.\nMETHODS: The GUIDANCE study was a retrospective, cross-sectional study from 2009-2010 based on the records of 7597 people in France, Belgium, Italy, the Netherlands, Sweden, UK, Ireland and Germany. We analysed the level of metabolic control achieved and blood glucose-lowering medication used in different age groups and in relation to accompanying diseases.\nRESULTS: 4.459 patients (59.1%) were 65\u00a0years or older. Their HbA1c levels were similar to those with <65\u00a0years. 44.7% of patients \u226565\u00a0years had an HbA1c \u22647% (53\u00a0mmol/mol) and were treated with insulin or sulfonylureas, and 27.1% of them had ischaemic heart disease or congestive heart failure. Significantly more patients with heart disease had HbA1c values \u22647% (53\u00a0mmol/mol) and were treated more often with insulin or sulfonylureas compared to patients of the same age without heart disease.\nCONCLUSIONS: Most patients were treated according to guidelines valid at the time this large international patient sample was surveyed. Older and younger patients were at a similar level of metabolic control, and almost half of the patients with an age of \u226565\u00a0years and treated with insulin or sulfonylurea had HbA1c levels below the target range (\u22647%) for younger patients. However, these patients have an increased risk of severe hypoglycaemic events with potentially dangerous complications, particularly in those with cardiovascular diseases.",
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