Qian Ren1, Li-Nong Ji2, Ju-Ming Lu3, Yu-Feng Li4, Quan-Min Li5, Shan-Shan Lin6, Xiao-Feng Lv7, Li Wang8, Yuan Xu9, Xiao-Hui Guo10, Qi-Yu Guo11, Li Ma12, Jin Du3, Ying-Li Chen1, Cui-Ling Zhao4, Qiu-Lan Zhang5, Qi-Mei She6, Xiu-Min Jiao7, Mei-Hua Lu8, Xiao-Meng Sun9, Ying Gao10, Jie Zhang12. 1. Department of Endocrinology, Peking University People's Hospital, Beijing 100035, China. 2. Department of Endocrinology, Peking University People's Hospital, Beijing 100035, China. Electronic address: jiln@bjmu.edu.cn. 3. Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China. 4. Department of Endocrinology, Pinggu Hospital, Beijing 101200, China. 5. Department of Endocrinology, The Second Artillery General Hospital of PLA, 100088, China. 6. Department of Endocrinology, Shijingshan Hospital, 100049, China. 7. Department of Endocrinology, General Hospital of Beijing Military Command, Beijing 100010, China. 8. Department of Endocrinology, Xuanwu Hospital of Capital Medical University, Beijing 100053, China. 9. Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100023, China. 10. Department of Endocrinology, Peking University First Hospital, Beijing 100034, China. 11. Department of Endocrinology, Navy General Hospital, Beijing 100048, China. 12. Department of Endocrinology, Guang An Men Hospital, China Academy of Chinese Medical Science, Beijing 102600, China.
Abstract
AIMS: Our aim was to search for clinical predictors of good glycemic control in patients starting or intensifying oral hypoglycemic pharmacological therapy. METHODS: A multicenter, prospective cohort of 499 diabetic subjects was enrolled in this study: patients with newly diagnosed diabetes (NDM group) or poor glycemic control with oral antidiabetic drugs (OADs) (PDM group). All subjects then started or intensified OADs therapy and followed up for 91 days. Glycemic control was determined according to HbA1c at day 91 with HbA1c <7% considered good. RESULTS: The proportions of patients with good glycemic control after follow up for 91 days were 66.9% and 34.8% in NDM group and PDM group respectively. Logistic regression analysis showed that the change in GA at 28 days was the only predictor of good glycemic control in NDM patients (OR = 1.630, 95% CI 1.300-2.044, P < 0.001). In PDM patients, changes in GA at 28 days, CPI, baseline HbA1c, diabetic duration, and BMI were all independent predictors of good glycemic control (All P < 0.05). CONCLUSIONS: GA decline is a good predictor of future success in newly diagnosed patients. In patients intensifying therapy, beside GA decline, other individualized clinical characteristics should also be considered.
AIMS: Our aim was to search for clinical predictors of good glycemic control in patients starting or intensifying oral hypoglycemic pharmacological therapy. METHODS: A multicenter, prospective cohort of 499 diabetic subjects was enrolled in this study: patients with newly diagnosed diabetes (NDM group) or poor glycemic control with oral antidiabetic drugs (OADs) (PDM group). All subjects then started or intensified OADs therapy and followed up for 91 days. Glycemic control was determined according to HbA1c at day 91 with HbA1c <7% considered good. RESULTS: The proportions of patients with good glycemic control after follow up for 91 days were 66.9% and 34.8% in NDM group and PDM group respectively. Logistic regression analysis showed that the change in GA at 28 days was the only predictor of good glycemic control in NDM patients (OR = 1.630, 95% CI 1.300-2.044, P < 0.001). In PDM patients, changes in GA at 28 days, CPI, baseline HbA1c, diabetic duration, and BMI were all independent predictors of good glycemic control (All P < 0.05). CONCLUSIONS: GA decline is a good predictor of future success in newly diagnosed patients. In patients intensifying therapy, beside GA decline, other individualized clinical characteristics should also be considered.