Managing type 2 diabetes mellitus: Role of family physicians in successful treatment goal achievement

Abstract

Introduction: It is important to emphasize that for most patients with type 2 diabetes mellitus (T2DM), an integrated approach to managing risk factors or the simultaneous modification of all increased risk factors is needed to help reduce the risk of cardiovascular events. Achieving an optimal level of glycated hemoglobin (HbA1c), blood pressure (BP) and LDL cholesterol (LDL) in patients softens macro-and microvascular complications, which is the main goal of treatment in the treatment of type 2 diabetes. This study was aimed at determining the proportion of patients with type 2 diabetes and the aforementioned variable conditions that achieve the triple goals of vascular treatment, based on current practical recommendations. Methods: A questionnaire was distributed to adult patients with T2DM and dyslipidemia at primary care clinics in Ukraine. The demographic and clinical data for these patients with both T2DM and dyslipidemia were compared with laboratory data and treatment data obtained from their medical records. The pooled data was then analyzed to determine the proportion of patients who achieved the triple treatment goals, and logistic regression analysis was used to identify the factors associated with this outcome. Results: 715 eligible patients were recruited [58.9% women] with an average age of 59.8 years. Of these patients, 71.2% achieved LDL-C ≤ 2.6 mmol / L, 70.1% had BP <140/90 mm Hg, and 41.2% reached HbA1c <6.5%. Overall, 23.1% achieved the triple goal of treating glycemia, blood pressure and LDL control. The main determinants were the number of diabetic drugs and the intensity of statin therapy. Conclusion: Eight out of ten patients with diabetes mellitus could not achieve the simultaneous goals of treating glycemia, blood pressure and LDL, putting them at risk for vascular complications. Primary health care professionals can reduce these risks by optimizing therapeutic treatment to maximize glycemia, dyslipidemia, and blood pressure control.