Multifaceted determinants for achieving glycemic control the international diabetes management practice study (IDMPS)

OBJECTIVE - The International Diabetes Mellitus Practice Study is a 5-year survey documenting changes in diabetes treatment practice in developing regions. RESEARCH DESIGN AND METHODS - Logistic regression analysis was used to identify factors for achieving A1C <7% in 11,799 patients (1,898 type...

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Autores principales: Chan, Juliana C. N., Gagliardino, Juan José, Baik, Sei Hyun, Chantelot, Jean Marc, Ferreira, Sandra R. G., Hancu, Nicolae, Ilkova, Hasan, Ramachandran, Ambady, Aschner, Pablo
Formato: Articulo
Lenguaje:Inglés
Publicado: 2009
Materias:
Ciencias Médicas
glycemic control
Acceso en línea:http://sedici.unlp.edu.ar/handle/10915/82691
Aporte de:
SEDICI (UNLP) de Universidad Nacional de La Plata
id I19-R120-10915-82691
record_format dspace
institution Universidad Nacional de La Plata
institution_str I-19
repository_str R-120
collection SEDICI (UNLP)
language Inglés
topic Ciencias Médicas
glycemic control
spellingShingle Ciencias Médicas
glycemic control
Chan, Juliana C. N.
Gagliardino, Juan José
Baik, Sei Hyun
Chantelot, Jean Marc
Ferreira, Sandra R. G.
Hancu, Nicolae
Ilkova, Hasan
Ramachandran, Ambady
Aschner, Pablo
Multifaceted determinants for achieving glycemic control the international diabetes management practice study (IDMPS)
topic_facet Ciencias Médicas
glycemic control
description OBJECTIVE - The International Diabetes Mellitus Practice Study is a 5-year survey documenting changes in diabetes treatment practice in developing regions. RESEARCH DESIGN AND METHODS - Logistic regression analysis was used to identify factors for achieving A1C <7% in 11,799 patients (1,898 type 1 diabetic and 9,901 type 2 diabetic) recruited by 937 physicians from 17 countries in Eastern Europe (n = 3,519), Asia (n = 5,888), Latin America (n = 2,116), and Africa (n = 276). RESULTS - Twenty-two percent of type 1 diabetic and 36% of type 2 diabetic patients never had A1C measurements. In those with values for A1C, blood pressure, and LDL cholesterol, 7.5% of type 1 diabetic (n = 696) and 3.6% of type 2 diabetic (n = 3,896) patients attained all three recommended targets (blood pressure < 130/80 mmHg, LDL cholesterol <100 mg/dl, and A1C <7%). Self-monitoring of blood glucose was the only predictor for achieving the A1C goal in type 1 diabetes (odds ratios: Asia 2.24, Latin America 3.55, and Eastern Europe 2.42). In type 2 diabetes, short disease duration (Asia 0.97, Latin America 0.97, and Eastern Europe 0.82) and treatment with few oral glucose-lowering drugs (Asia 0.64, Latin America 0.76, and Eastern Europe 0.62) were predictors. Other region-specific factors included lack of microvascular complications and old age in Latin America and Asia; health insurance coverage and specialist care in Latin America; lack of obesity and self-adjustment of insulin dosages in Asia; and training by a diabetes educator, self-monitoring of blood glucose in patients who self-adjusted insulin, and lack of macrovascular complications in Eastern Europe. CONCLUSIONS - In developing countries, factors pertinent to patients, doctors, and health care systems all impact on glycemic control.
format Articulo
Articulo
author Chan, Juliana C. N.
Gagliardino, Juan José
Baik, Sei Hyun
Chantelot, Jean Marc
Ferreira, Sandra R. G.
Hancu, Nicolae
Ilkova, Hasan
Ramachandran, Ambady
Aschner, Pablo
author_facet Chan, Juliana C. N.
Gagliardino, Juan José
Baik, Sei Hyun
Chantelot, Jean Marc
Ferreira, Sandra R. G.
Hancu, Nicolae
Ilkova, Hasan
Ramachandran, Ambady
Aschner, Pablo
author_sort Chan, Juliana C. N.
title Multifaceted determinants for achieving glycemic control the international diabetes management practice study (IDMPS)
title_short Multifaceted determinants for achieving glycemic control the international diabetes management practice study (IDMPS)
title_full Multifaceted determinants for achieving glycemic control the international diabetes management practice study (IDMPS)
title_fullStr Multifaceted determinants for achieving glycemic control the international diabetes management practice study (IDMPS)
title_full_unstemmed Multifaceted determinants for achieving glycemic control the international diabetes management practice study (IDMPS)
title_sort multifaceted determinants for achieving glycemic control the international diabetes management practice study (idmps)
publishDate 2009
url http://sedici.unlp.edu.ar/handle/10915/82691
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