Simultaneous control of blood glucose, blood pressure, and lipid among drug-treated Type 2 diabetes patients from Shaanxi province, North-Western China: A multicenter study
S Xu1, F Sun1, W Xu2, K Jiao3, B Shi4, X Xie5, Y Wang6, M Zhu7, Q Ji1
1 Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
2 Department of Dermatology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
3 Department of Endocrinology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
4 Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
5 Department of Endocrinology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
6 Department of Endocrinology, Shaanxi Provincial People's Hospital, Xi'an, China
7 Department of Nutrition, Xi'an Municipal Central Hospital, Xi'an, China
Prof. Q Ji
Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, 169 Changle West Road, Xi'an 710032
Source of Support: None, Conflict of Interest: None
Aim: To investigate the percentage of patients with Type 2 diabetes mellitus (T2DM) who achieved simultaneous control of glycated hemoglobin (HbA1c), blood pressure (BP), and low-density lipoprotein cholesterol (LDL-C) and also to assess its determinants in Shaanxi province, North-Western China.
Materials and Methods: This cross-sectional survey was conducted between March and June 2012 in six tertiary hospitals across Shaanxi province. Subjects with known T2DM who had at least one antidiabetic medicine were invited. A questionnaire was used to collect basic information and blood samples were drawn for laboratory measurements. Simultaneous control was defined as HbA1c <7%, BP <130/80 mmHg, and LDL-C <2.6 mmol/L.
Results: A total of 2274 individuals were included, of which 588 individuals (25.9%) achieved good glycemic control (HbA1c <7%) and only 102 (4.5%) attained simultaneous control. The percentage of individuals (24.2%) achieving simultaneous control increased with less stringent goals (HbA1c <8%, BP <140/90 mmHg, and LDL-C <2.8 mmol/L). In addition, multivariate analyses showed that body mass index of 24–28 kg/m2 (odds ratio [OR]: 0.577, 95% confidence interval [CI]: 0.376–0.886), HbA1c above 8% at diagnosis (pooled OR: 0.392, 95% CI: 0.254–0.531), and insulin treatment (pooled OR: 0.412, 95% CI: 0.225–0.594) were the independent predictors of simultaneous control.
Conclusion: Simultaneous control among drug-treated Type 2 diabetes patients was amazingly low in North-Western China. Our present study confirmed the gap between guideline and practice and provided evidence of the need for aggressive diabetes management.