Prevalence of inadequate glycemic control among patients with type 2 diabetes in the United Kingdom general practice research database: A series of retrospective analyses of data from 1998 through 2002. Fox, K. M., Gerber Pharmd, R. A., Bolinder, B., Chen, J., & Kumar, S. Clinical Therapeutics, 28(3):388--395, March, 2006. doi abstract bibtex BACKGROUND: Since the mid-1990s, the development of new oral antidiabetic agents (OAs) and treatment guidelines have created an opportunity to improve glycemic control in patients with type 2 diabetes. OBJECTIVES: This study aimed to assess the prevalence of good and inadequate glycemic control across a 5-year period among patients with diabetes in the United Kingdom. It also investigated the factors associated with achieving glycemic targets. METHODS: This was a retrospective, cross-sectional analysis of data from the General Practice Research Database. Three limits were used to assess glycosylated hemoglobin (HbA1c): 6.5%, 7.0%, or 7.5%. Values above the cutoffs indicated inadequate control of HbA1c; those at or below the cutoffs indicated good control. The study evaluated clinical and pharmacy data from the years 1998 to 2002 for patients with type 2 diabetes, \textgreater or =2 years of follow-up, and \textgreater or =2 HbA1c measurements during the first year. Five independent cross-sectional analyses were conducted, grouping data by year. Statistical significance was determined by Student t and chi2 tests. RESULTS: Data were analyzed for 10,663 patients aged 17 to 98 years. The number of total eligible type 2 diabetes patients increased over the course of the study period: 5674 patients in 1998, 6553 in 1999, 7314 in 2000, 7323 in 2001, and 6192 in 2002. Overall, the study population had a mean (SD) age of 66 (11.0) years, was 53% male (3033/5674), and had a body mass index of 29 kg/m(2). Seventy-six percent of patients had HbA1c \textgreater7.0% and 37% were taking \textgreater or =2 oral agents. In 1998 and 2002, 79% (4482/5674) and 76% (4732/6192) of patients, respectively, had inadequate glycemic control, defined as HbA1c \textgreater7.0%. When defined as HbA1c \textgreater7.5%, 69% (3923/5674) and 62% (3814/6192) of patients, respectively, had inadequate control. Finally, when defined as HbA1c \textgreater6.5%, 88% (5011/5674) of patients in both 1998 and 2002 had inadequate control. Compared with patients with good disease control (HbA1c \textless or =7.0%), patients with inadequate control were approximately 2 years younger (P \textless 0.001) and had been prescribed more OAs: 41% received \textgreater or =2 OAs in 1998 and 52% in 2002, compared with 23% and 34% (both, P = 0.001), respectively, of patients with good glycemic control (P \textless 0.02). Sex, number of diabetes complications, and number of comorbidities did not differ between groups (P = NS). CONCLUSIONS: Despite the introduction of new OAs and treatment guidelines, the prevalence of inadequate glycemic control remains high (\textgreater60%) in patients with type 2 diabetes in the United Kingdom. Regardless of the HbA1c cutoff, patients with inadequate control were younger and received prescriptions for more OAs than patients with good control.
@article{fox_prevalence_2006,
title = {Prevalence of inadequate glycemic control among patients with type 2 diabetes in the {United} {Kingdom} general practice research database: {A} series of retrospective analyses of data from 1998 through 2002},
volume = {28},
issn = {0149-2918},
shorttitle = {Prevalence of inadequate glycemic control among patients with type 2 diabetes in the {United} {Kingdom} general practice research database},
doi = {10.1016/j.clinthera.2006.03.005},
abstract = {BACKGROUND: Since the mid-1990s, the development of new oral antidiabetic agents (OAs) and treatment guidelines have created an opportunity to improve glycemic control in patients with type 2 diabetes.
OBJECTIVES: This study aimed to assess the prevalence of good and inadequate glycemic control across a 5-year period among patients with diabetes in the United Kingdom. It also investigated the factors associated with achieving glycemic targets.
METHODS: This was a retrospective, cross-sectional analysis of data from the General Practice Research Database. Three limits were used to assess glycosylated hemoglobin (HbA1c): 6.5\%, 7.0\%, or 7.5\%. Values above the cutoffs indicated inadequate control of HbA1c; those at or below the cutoffs indicated good control. The study evaluated clinical and pharmacy data from the years 1998 to 2002 for patients with type 2 diabetes, {\textgreater} or =2 years of follow-up, and {\textgreater} or =2 HbA1c measurements during the first year. Five independent cross-sectional analyses were conducted, grouping data by year. Statistical significance was determined by Student t and chi2 tests.
RESULTS: Data were analyzed for 10,663 patients aged 17 to 98 years. The number of total eligible type 2 diabetes patients increased over the course of the study period: 5674 patients in 1998, 6553 in 1999, 7314 in 2000, 7323 in 2001, and 6192 in 2002. Overall, the study population had a mean (SD) age of 66 (11.0) years, was 53\% male (3033/5674), and had a body mass index of 29 kg/m(2). Seventy-six percent of patients had HbA1c {\textgreater}7.0\% and 37\% were taking {\textgreater} or =2 oral agents. In 1998 and 2002, 79\% (4482/5674) and 76\% (4732/6192) of patients, respectively, had inadequate glycemic control, defined as HbA1c {\textgreater}7.0\%. When defined as HbA1c {\textgreater}7.5\%, 69\% (3923/5674) and 62\% (3814/6192) of patients, respectively, had inadequate control. Finally, when defined as HbA1c {\textgreater}6.5\%, 88\% (5011/5674) of patients in both 1998 and 2002 had inadequate control. Compared with patients with good disease control (HbA1c {\textless} or =7.0\%), patients with inadequate control were approximately 2 years younger (P {\textless} 0.001) and had been prescribed more OAs: 41\% received {\textgreater} or =2 OAs in 1998 and 52\% in 2002, compared with 23\% and 34\% (both, P = 0.001), respectively, of patients with good glycemic control (P {\textless} 0.02). Sex, number of diabetes complications, and number of comorbidities did not differ between groups (P = NS).
CONCLUSIONS: Despite the introduction of new OAs and treatment guidelines, the prevalence of inadequate glycemic control remains high ({\textgreater}60\%) in patients with type 2 diabetes in the United Kingdom. Regardless of the HbA1c cutoff, patients with inadequate control were younger and received prescriptions for more OAs than patients with good control.},
language = {eng},
number = {3},
journal = {Clinical Therapeutics},
author = {Fox, Kathleen M. and Gerber Pharmd, Robert A. and Bolinder, Bjorn and Chen, Jack and Kumar, Sanjaya},
month = mar,
year = {2006},
pmid = {16750453},
keywords = {Administration, Oral, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Body Mass Index, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Family Practice, Female, Great Britain, Hemoglobin A, Glycosylated, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Prevalence, Retrospective Studies, databases as topic},
pages = {388--395}
}
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A.","Bolinder, B.","Chen, J.","Kumar, S."],"year":2006,"bibtype":"article","biburl":"http://bibbase.org/zotero/veegee78","bibdata":{"bibtype":"article","type":"article","title":"Prevalence of inadequate glycemic control among patients with type 2 diabetes in the United Kingdom general practice research database: A series of retrospective analyses of data from 1998 through 2002","volume":"28","issn":"0149-2918","shorttitle":"Prevalence of inadequate glycemic control among patients with type 2 diabetes in the United Kingdom general practice research database","doi":"10.1016/j.clinthera.2006.03.005","abstract":"BACKGROUND: Since the mid-1990s, the development of new oral antidiabetic agents (OAs) and treatment guidelines have created an opportunity to improve glycemic control in patients with type 2 diabetes. OBJECTIVES: This study aimed to assess the prevalence of good and inadequate glycemic control across a 5-year period among patients with diabetes in the United Kingdom. It also investigated the factors associated with achieving glycemic targets. METHODS: This was a retrospective, cross-sectional analysis of data from the General Practice Research Database. Three limits were used to assess glycosylated hemoglobin (HbA1c): 6.5%, 7.0%, or 7.5%. Values above the cutoffs indicated inadequate control of HbA1c; those at or below the cutoffs indicated good control. The study evaluated clinical and pharmacy data from the years 1998 to 2002 for patients with type 2 diabetes, \\textgreater or =2 years of follow-up, and \\textgreater or =2 HbA1c measurements during the first year. Five independent cross-sectional analyses were conducted, grouping data by year. Statistical significance was determined by Student t and chi2 tests. RESULTS: Data were analyzed for 10,663 patients aged 17 to 98 years. The number of total eligible type 2 diabetes patients increased over the course of the study period: 5674 patients in 1998, 6553 in 1999, 7314 in 2000, 7323 in 2001, and 6192 in 2002. Overall, the study population had a mean (SD) age of 66 (11.0) years, was 53% male (3033/5674), and had a body mass index of 29 kg/m(2). Seventy-six percent of patients had HbA1c \\textgreater7.0% and 37% were taking \\textgreater or =2 oral agents. In 1998 and 2002, 79% (4482/5674) and 76% (4732/6192) of patients, respectively, had inadequate glycemic control, defined as HbA1c \\textgreater7.0%. When defined as HbA1c \\textgreater7.5%, 69% (3923/5674) and 62% (3814/6192) of patients, respectively, had inadequate control. Finally, when defined as HbA1c \\textgreater6.5%, 88% (5011/5674) of patients in both 1998 and 2002 had inadequate control. Compared with patients with good disease control (HbA1c \\textless or =7.0%), patients with inadequate control were approximately 2 years younger (P \\textless 0.001) and had been prescribed more OAs: 41% received \\textgreater or =2 OAs in 1998 and 52% in 2002, compared with 23% and 34% (both, P = 0.001), respectively, of patients with good glycemic control (P \\textless 0.02). Sex, number of diabetes complications, and number of comorbidities did not differ between groups (P = NS). CONCLUSIONS: Despite the introduction of new OAs and treatment guidelines, the prevalence of inadequate glycemic control remains high (\\textgreater60%) in patients with type 2 diabetes in the United Kingdom. Regardless of the HbA1c cutoff, patients with inadequate control were younger and received prescriptions for more OAs than patients with good control.","language":"eng","number":"3","journal":"Clinical Therapeutics","author":[{"propositions":[],"lastnames":["Fox"],"firstnames":["Kathleen","M."],"suffixes":[]},{"propositions":[],"lastnames":["Gerber","Pharmd"],"firstnames":["Robert","A."],"suffixes":[]},{"propositions":[],"lastnames":["Bolinder"],"firstnames":["Bjorn"],"suffixes":[]},{"propositions":[],"lastnames":["Chen"],"firstnames":["Jack"],"suffixes":[]},{"propositions":[],"lastnames":["Kumar"],"firstnames":["Sanjaya"],"suffixes":[]}],"month":"March","year":"2006","pmid":"16750453","keywords":"Administration, Oral, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Body Mass Index, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Family Practice, Female, Great Britain, Hemoglobin A, Glycosylated, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Prevalence, Retrospective Studies, databases as topic","pages":"388--395","bibtex":"@article{fox_prevalence_2006,\n\ttitle = {Prevalence of inadequate glycemic control among patients with type 2 diabetes in the {United} {Kingdom} general practice research database: {A} series of retrospective analyses of data from 1998 through 2002},\n\tvolume = {28},\n\tissn = {0149-2918},\n\tshorttitle = {Prevalence of inadequate glycemic control among patients with type 2 diabetes in the {United} {Kingdom} general practice research database},\n\tdoi = {10.1016/j.clinthera.2006.03.005},\n\tabstract = {BACKGROUND: Since the mid-1990s, the development of new oral antidiabetic agents (OAs) and treatment guidelines have created an opportunity to improve glycemic control in patients with type 2 diabetes.\nOBJECTIVES: This study aimed to assess the prevalence of good and inadequate glycemic control across a 5-year period among patients with diabetes in the United Kingdom. It also investigated the factors associated with achieving glycemic targets.\nMETHODS: This was a retrospective, cross-sectional analysis of data from the General Practice Research Database. Three limits were used to assess glycosylated hemoglobin (HbA1c): 6.5\\%, 7.0\\%, or 7.5\\%. Values above the cutoffs indicated inadequate control of HbA1c; those at or below the cutoffs indicated good control. The study evaluated clinical and pharmacy data from the years 1998 to 2002 for patients with type 2 diabetes, {\\textgreater} or =2 years of follow-up, and {\\textgreater} or =2 HbA1c measurements during the first year. Five independent cross-sectional analyses were conducted, grouping data by year. Statistical significance was determined by Student t and chi2 tests.\nRESULTS: Data were analyzed for 10,663 patients aged 17 to 98 years. The number of total eligible type 2 diabetes patients increased over the course of the study period: 5674 patients in 1998, 6553 in 1999, 7314 in 2000, 7323 in 2001, and 6192 in 2002. Overall, the study population had a mean (SD) age of 66 (11.0) years, was 53\\% male (3033/5674), and had a body mass index of 29 kg/m(2). Seventy-six percent of patients had HbA1c {\\textgreater}7.0\\% and 37\\% were taking {\\textgreater} or =2 oral agents. In 1998 and 2002, 79\\% (4482/5674) and 76\\% (4732/6192) of patients, respectively, had inadequate glycemic control, defined as HbA1c {\\textgreater}7.0\\%. When defined as HbA1c {\\textgreater}7.5\\%, 69\\% (3923/5674) and 62\\% (3814/6192) of patients, respectively, had inadequate control. Finally, when defined as HbA1c {\\textgreater}6.5\\%, 88\\% (5011/5674) of patients in both 1998 and 2002 had inadequate control. Compared with patients with good disease control (HbA1c {\\textless} or =7.0\\%), patients with inadequate control were approximately 2 years younger (P {\\textless} 0.001) and had been prescribed more OAs: 41\\% received {\\textgreater} or =2 OAs in 1998 and 52\\% in 2002, compared with 23\\% and 34\\% (both, P = 0.001), respectively, of patients with good glycemic control (P {\\textless} 0.02). Sex, number of diabetes complications, and number of comorbidities did not differ between groups (P = NS).\nCONCLUSIONS: Despite the introduction of new OAs and treatment guidelines, the prevalence of inadequate glycemic control remains high ({\\textgreater}60\\%) in patients with type 2 diabetes in the United Kingdom. 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