Achievement of objectives in adult patients with type 1 diabetes mellitus: estimated glucose disposition rate as a clinical marker

Authors

  • Alejandra Cicchitti Faculty of Medical Sciences, University Hospital, National University of Cuyo, Mendoza, Argentina
  • Edgardo Trinajstic Faculty of Medical Sciences, University Hospital, National University of Cuyo, Mendoza, Argentina
  • Joaquín González Faculty of Medical Sciences, University Hospital, National University of Cuyo, Mendoza, Argentina
  • Celina Bertona Faculty of Medical Sciences, University Hospital, National University of Cuyo, Mendoza, Argentina
  • Luis Lombardo Guaymallén Health Area, Ministry of Health, Mendoza, Argentina
  • Martín Rodríguez Faculty of Medical Sciences, University Hospital, National University of Cuyo, Mendoza, Argentina

DOI:

https://doi.org/10.47196/diab.v56i3.527

Keywords:

type 1 diabetes mellitus, therapeutic targets, c-LDL, HbA1c, smoking, physical activity, blood pressure, estimated glucose disposition rate

Abstract

Introduction: the clinical practice guidelines in diabetes mellitus (DM) establish precise clinical objectives for the good management of the disease, but little is known about adequate compliance in our environment. Being overweight and sedentary have generated stigmas of metabolic syndrome in the population with DM1.

Objectives: to evaluate the compliance with 5 of these criteria: HbA1c <7%, c-LDL ≤100 mg/dL, physical activity (PA) ≥3 times/week, systolic blood preasure (SBP) <140 mm Hg, and no smoking and its association with insulin resistance determined by the estimated glucose disposition rate (eGDR).

Material and methods: in 415 DM1 ≥18 years, 52% women, age 34.8±13.9 years, HbA1c, c-LDL, weekly frequency of structured PA, SBP, and current smoking were evaluated. The degree of association with gender, age, age of DM, level of education, medical coverage, BMI, and insulin sensitivity measured through eGDR was determined. Qualitative variables were analyzed by chi-square test and quantitative variables by ANOVA I test and analysis post hoc by Tukey's test for multiple comparisons. A value of p<0.05 was considered statistically significant. A 95% confidence interval was used in all cases.

Results: systolic BP <140 mm Hg presented 94.8%, current non-smoking 82.2%, c-LDL ≤ 100 mg/dL 56.5%, physical activity (PA) ≥3 times a week 39% and HbA1c <7% 20.3%. Only 26 patients (6.2%) achieved the 5 objectives analyzed in combination. The fulfillment of the 5 objectives was associated at the level of ≥ secondary education (p=0.002) and health coverage with social welfare or prepaid (p=0.002). There was a significant association between TeDG in those who fulfilled the 5 objectives (p=0.02) and individually in 4 of them (SPB, c-LDL, HbA1c, and PA).

Conclusions: of the 415 patients evaluated in our study, only 6.2% met the 5 criteria under consideration. Only control of SBP, non-smoking and c-LDL <100 were complied with by the majority of the patients. HbA1c <7% was the individual objective with the lowest degree of compliance.

Author Biographies

Alejandra Cicchitti, Faculty of Medical Sciences, University Hospital, National University of Cuyo, Mendoza, Argentina

Professor, Faculty of Medical Sciences; Staff Physician, University Hospital, National University of Cuyo

Edgardo Trinajstic, Faculty of Medical Sciences, University Hospital, National University of Cuyo, Mendoza, Argentina

Professor, Faculty of Medical Sciences, Staff Physician, University Hospital, National University of Cuyo

Joaquín González, Faculty of Medical Sciences, University Hospital, National University of Cuyo, Mendoza, Argentina

Professor, Faculty of Medical Sciences; Staff Physician, University Hospital, National University of Cuyo

Celina Bertona, Faculty of Medical Sciences, University Hospital, National University of Cuyo, Mendoza, Argentina

Professor, Faculty of Medical Sciences; Staff Physician, University Hospital, National University of Cuyo

Luis Lombardo, Guaymallén Health Area, Ministry of Health, Mendoza, Argentina

Staff Physician

Martín Rodríguez, Faculty of Medical Sciences, University Hospital, National University of Cuyo, Mendoza, Argentina

Professor, Faculty of Medical Sciences; Staff Physician, University Hospital, National University of Cuyo

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Published

2022-12-01

How to Cite

Cicchitti, A., Trinajstic, E., González, J., Bertona, C., Lombardo, L., & Rodríguez, M. (2022). Achievement of objectives in adult patients with type 1 diabetes mellitus: estimated glucose disposition rate as a clinical marker. Journal of the Argentine Society of Diabetes, 56(3), 93–100. https://doi.org/10.47196/diab.v56i3.527

Issue

Vol. 56 No. 3 (2022): September/December 2022

Section

Original article

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