More than half patients of diabetes don't meet recommended targets of A1C and BP: Study

Brazil: More than half of type 2 diabetes outpatients do not meet the recommended target values of glycated hemoglobin (A1C) and blood pressure, finds a recent study by Dr. Camila Bergonsi and the team from Brazil.

"Because of which there is a major call to overcome the target treatment and therapeutic inertia of patients on an individual basis, the authors wrote in the Canadian Journal of Diabetes.

Dr. Bergonsi and the team aimed to determine the proportion of type 2 diabetes patients achieving glycated hemoglobin and blood pressure targets in preventing chronic vascular complications in diabetes. It was found that more than half of type 2 diabetes outpatients do not meet the recommended A1C and blood pressure target values. 

A cross-sectional study was conducted in an outpatient endocrine clinic at University Hospital, Brazil. The study comprised a total of 602 type 2 diabetes patients. The A1C goal was 7% in general and 8% for patients with advanced chronic complications. The overall expected target for blood pressure was 140/90 mmHg.

It was reported that the study analyzed 62% female and 14% black. The mean age was 63 years, mean diabetes duration was 17 years and median A1C was 8.0%.

The key highlights of the study were;

• 33 percent of the patients had macrovascular disease, 47 percent with diabetic retinopathy, 43 percent with peripheral neuropathy and 56 percent with diabetic kidney disease.

• 67 percent of patients did not attain the adjusted target A1C level which showed poor metabolic control.

• 58 percent of patients did not reach the recommended targets due to major determinants, of which a more advanced age was the main associated factor.

• Female, black and younger individuals presented worse glycemic control.

• Patients with worse blood pressures were older, with a higher prevalence of diabetes complications

The lead author concluded, that this is a major call to overcome the therapeutic inertia and target treatment of patients on an individual basis.

For further details

Bergonsi de Farias, C., Coelli, S., Satler, F., Brondani, L., Zelmanovitz, T., & Silveiro, S. P. (2021). Glycated Hemoglobin and Blood Pressure Levels in Adults with Type 2 Diabetes: How Many Patients Are on Target? Canadian Journal of Diabetes, 45(4), 334–340. https://doi.org/10.1016/j.jcjd.2020.10.002