P55 Factors associated with glycemic goal achievement in Type 2 Diabetes

Abstract

Introduction: Glycemic goal achievement is a matter of great health impact. Adequate glycemic control prevents and decreases diabetes chronic complications and prolongs survival.

Aims: To investigate the percentage of people with Type 2 Diabetes (T2D) who reach the treatment goal (A1c) and the variables associated with achieving the glycemic goal. Material and methods: Multicenter, descriptive, observational cross-sectional study in 28 centers specialized in Diabetes in Argentina (FRADYC III Group), year 2018. Physical examination, laboratory and treatment of T2D were evaluated in routine practice. The glycemic goal was A1c < 7%. We evaluated adherence to pharmacological treatment with the Morisky-Green-Levine test and quality of life with the WHO-5 test, considering a low well-being score of less than 50 and symptoms of depression less than 28. Univariate analysis and multiple logistic regression of factors associated with lower achievement of treatment goals were performed. We considered age groups (under 50 ys, between 50 to 65 ys and over 65 ys). Any value of p< 0.05 (2 tails) was considered significant with the STATA Intercooler Software.

Results: Of 1329 persons with T2D, women 46.6%, age 61.9 ± 11.6 ys, A1c 7 ± 1.4%,

FPG: 135 ± 40.4 mg/dl, time of T2D diagnosis 9.6 ± 7.4 ys, BMI 31.7 ± 5.7 kg/m2, smoked

11.6%, arterial hypertension 81%, dyslipidemia 81.4%, exercised (> 150 min/week)

29.8%, annual visits 4.3 ± 2.3, SMBG 76%, having a private health insurance 43.49%. Mild/moderate hypoglycemia rate was 4.3% in last week, severe 0.38% last year. Most prevalent chronic complications being cardiovascular disease 37.2% and neuropathy 19.1%. With symptoms suggestive of depression in 29.3%. Were adherent to pharmacological treatment 68.4%. Reached glycemic objective of A1c < 7%, 60.2%. Diabetes treatment: non pharmacological treatment 5.1%, 1 drug 47.5%, 2 drugs 34.5%, 3 or more drugs 12.9%, with insulin 38.1%. Worst glycemic control was associated with: time of diabetes diagnosis (OR: 0.93; IC 95% 0.92-0.95, p<0.0001), and depression symptoms (OR: 0.53, IC 95% 0.36-0.79, p<0.002) (multiple logistic regression). Achievement of glycemic goal was associated with: being older than 65 ys (OR: 2.75, IC 95% 1.84-4.11, p<0,0001), pharmacological treatment adherence (OR: 1.53, IC 95%

1.17-2.00, p<0.0001), having a private health insurance (R: 2.29, IC 95% 1.77-2.96,

p<0.0001), and exercising (OR: 1.33, IC 95% 1.04-1.72, p< 0.02).

Conclusions: In this population, 60.2% reached the goal of an A1c < 7%. Achieving the glycemic aim was associated with being older than 65 ys, being adherent to pharmacological therapy, having a private health insurance and doing physical activity.