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Health & Wellness
Real-World Adequacy of Glycaemic Control in Treatment-Naïve Greek Patients with Type 2 Diabetes Mellitus Initiating Treatment with Metformin
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<blockquote data-quote="madman" data-source="post: 135928" data-attributes="member: 13851"><p><strong>Real-World Adequacy of Glycaemic Control in Treatment-Naïve Greek Patients with Type 2 Diabetes Mellitus Initiating Treatment with Metformin Monotherapy at the Maximum Tolerated Dose: The Reload Study </strong></p><p><strong></strong></p><p></p><p></p><p></p><p></p><p></p><p></p><p><strong>ABSTRACT</strong></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Background </span></strong>Metformin, in the absence of contraindications or intolerance, is recommended as first-line treatment for patients with type 2 diabetes mellitus (T2DM). This observational, retrospective study assessed the real-world adequacy of glycaemic control in Greek patients with T2DM initiating metformin monotherapy at maximum tolerated dose. </p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Methods</span></strong> Included patients received metformin monotherapy for ≥ 24 months; relevant patient data were collected immediately prior to metformin initiation (baseline) and at other prespecified time points. The primary objective was to report, after 9 months of metformin treatment, the percentage of patients with baseline glycated haemoglobin (HbA1c) levels ≥ 6.5 % ( ≥ 48 mmol/mol) achieving HbA1c < 6.5 %. Secondary objectives included the assessment of time spent with poor glycaemic control and time to treatment intensification. A sensitivity analysis assessed the percentage of patients with baseline HbA1c ≥ 7 % ( ≥ 53 mmol/mol) achieving HbA1c < 7 % ( < 53 mmol/mol). </p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Results</span></strong> Of the enrolled patients (N = 316), 247 had baseline HbA1c ≥ 6.5 %; following 9 months on metformin, 90 (36.4 %) patients achieved HbA1c < 6.5 % (mean HbA1c change − 1.3 % [ − 14 mmol/mol]). Median time of exposure to HbA1c ≥ 6.5 % was 23.4 months and time to treatment intensification was 28.0 months. The sensitivity analysis revealed that the proportion of patients achieving HbA1c < 7.0 % was 50 % (mean HbA1c change − 1.6 % [ − 17 mmol/mol]). </p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Conclusion </span></strong>Irrespective of HbA1c target assessed, most patients with T2DM do not achieve the recommended HbA1c goals after 9 months on metformin while remained on monotherapy for up to 24 months. Addressing clinical inertia could improve disease outcomes and, possibly, economic burden.</p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p>In conclusion, <strong><span style="color: rgb(184, 49, 47)">this real-world study provides evidence that the adequacy of metformin monotherapy is suboptimal in Greek patients with T2DM.</span></strong> Despite the availability of treatment guidelines, clinical inertia appears to be common and it remains important to further explore the factors that contribute to this phenomenon.</p></blockquote><p></p>
[QUOTE="madman, post: 135928, member: 13851"] [B]Real-World Adequacy of Glycaemic Control in Treatment-Naïve Greek Patients with Type 2 Diabetes Mellitus Initiating Treatment with Metformin Monotherapy at the Maximum Tolerated Dose: The Reload Study [/B] [B]ABSTRACT[/B] [B][COLOR=rgb(184, 49, 47)]Background [/COLOR][/B]Metformin, in the absence of contraindications or intolerance, is recommended as first-line treatment for patients with type 2 diabetes mellitus (T2DM). This observational, retrospective study assessed the real-world adequacy of glycaemic control in Greek patients with T2DM initiating metformin monotherapy at maximum tolerated dose. [B][COLOR=rgb(184, 49, 47)]Methods[/COLOR][/B] Included patients received metformin monotherapy for ≥ 24 months; relevant patient data were collected immediately prior to metformin initiation (baseline) and at other prespecified time points. The primary objective was to report, after 9 months of metformin treatment, the percentage of patients with baseline glycated haemoglobin (HbA1c) levels ≥ 6.5 % ( ≥ 48 mmol/mol) achieving HbA1c < 6.5 %. Secondary objectives included the assessment of time spent with poor glycaemic control and time to treatment intensification. A sensitivity analysis assessed the percentage of patients with baseline HbA1c ≥ 7 % ( ≥ 53 mmol/mol) achieving HbA1c < 7 % ( < 53 mmol/mol). [B][COLOR=rgb(184, 49, 47)]Results[/COLOR][/B] Of the enrolled patients (N = 316), 247 had baseline HbA1c ≥ 6.5 %; following 9 months on metformin, 90 (36.4 %) patients achieved HbA1c < 6.5 % (mean HbA1c change − 1.3 % [ − 14 mmol/mol]). Median time of exposure to HbA1c ≥ 6.5 % was 23.4 months and time to treatment intensification was 28.0 months. The sensitivity analysis revealed that the proportion of patients achieving HbA1c < 7.0 % was 50 % (mean HbA1c change − 1.6 % [ − 17 mmol/mol]). [B][COLOR=rgb(184, 49, 47)]Conclusion [/COLOR][/B]Irrespective of HbA1c target assessed, most patients with T2DM do not achieve the recommended HbA1c goals after 9 months on metformin while remained on monotherapy for up to 24 months. Addressing clinical inertia could improve disease outcomes and, possibly, economic burden. In conclusion, [B][COLOR=rgb(184, 49, 47)]this real-world study provides evidence that the adequacy of metformin monotherapy is suboptimal in Greek patients with T2DM.[/COLOR][/B] Despite the availability of treatment guidelines, clinical inertia appears to be common and it remains important to further explore the factors that contribute to this phenomenon. [/QUOTE]
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Real-World Adequacy of Glycaemic Control in Treatment-Naïve Greek Patients with Type 2 Diabetes Mellitus Initiating Treatment with Metformin
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