Prevalence of Poor Glycemic Control among Type 2 Diabetes Patients: A Retrospective Study from GPRD
Abstract Number: 2411-PO
Authors: KATHLEEN M. FOX, ROBERT A. GERBER, BJORN BOLINDER, JACK CHEN, SANJAYA KUMAR
Institutions: Monkton, MD; Groton, CT; Bridgewater, NJ; Milpitas, CA
Results: The aim of the study was to assess the prevalence of glycemic control among patients with type 2 diabetes (T2DM) as well as the differentiating characteristics of patients achieving and not achieving glycemic control. A retrospective cross-sectional analysis of the General Practice Research Database (GPRD), which includes patient records from general practice for 5% of the UK population, was undertaken to compare patients with T2DM whose A1C levels were >7% (poor glycemic control group) to those with A1C levels <7% (good glycemic control group). Clinical and pharmacy data from years 1998 and 2002 were utilized, and patients with ≥2 A1C values in each year were included. A total of 5674 patients with T2DM were included in the 1998 analysis, 79% of whom exhibited poor control with a median A1C of 8.5%. Compared with the good glycemic control group, patients with poor control were younger and had been prescribed more antidiabetic agents (≥2 oral agents [OAs] in 41% vs 23% in the good control group). The poor control group was more likely to be receiving insulin therapy than the good control group (7% vs 1.2%). In the 2002 analysis, the same pattern was seen with 76% of patients with T2DM (N=6192) having A1C levels >7% and 48% having A1C levels >8%. As in the 1998 analysis, the poor control group had been prescribed more antidiabetic agents than the good control group (≥2 OAs in 52% vs 34%) and was more likely to be on insulin with or without OAs (17% vs 6.5%). Gender, number of diabetes complications, and other comorbid conditions did not differ between groups in either 1998 or 2002. We conclude that poor glycemic control still is prevalent among patients with T2DM despite evidence supporting good glycemic control from the Diabetes Control and Complications Trial, the United Kingdom Prospective Diabetes Study, publication of the ADA guidelines for diabetes management, and the availability of more OAs.