ArticleInternational journal of clinical practice2009
Drug titration patterns and HbA 1c levels in type 2 diabetes.
Article in International journal of clinical practice, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Metformin dose up-titration and glycemic control in type 2 diabetes in a resource-limited setting, northern Ethiopia: a retrospective cohort study.BMC endocrine disorders · 2026Article
- Dual Therapy Appears Superior to Monotherapy for Low-Income Individuals With Newly Diagnosed Type 2 Diabetes.Journal of primary care & community health · 2017Article
- Diabetes treatment intensification and associated changes in HbA1c and body mass index: a cohort study.BMC endocrine disorders · 2016Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate oral antidiabetes drug (OAD) use, haemoglobin A(1c) (HbA(1c)) testing and glycaemic control in type 2 diabetes patients. STUDY
designRetrospective analysis based on claims data from the Integrated Healthcare Information Services (IHCIS) National Managed Care Benchmark Database.
methodsOAD use and HbA(1c) testing were analysed for patients with >or= 2 claims indicating diagnosis of type 2 diabetes and >or= 1 90-day OAD treatment period between 1 January, 2000 and 30 June, 2006. Likelihood of HbA(1c) testing was examined using multivariable logistic regression analyses, adjusting for OAD regimen and patients' sociodemographical characteristics.
resultsPatients were classified based on initial OAD regimen: metformin (MET) (n = 22,203; 41.3%), sulphonylurea (SFU) (n = 18,439; 34.3%), thiazolidinedione (TZD) (n = 7663; 14.3%), SFU + MET (n = 5467; 10.2%) and TZD + MET (n = 2355; 4.2%). A total of 51.5% of patients had HbA(1c) testing during 90 days preceding OAD initiation through regimen completion. Approximately, 65% of MET and 58% of SFU patients had no titration of initial regimen. Patients demonstrating inadequate glucose control decreased from 68.5% at baseline to 46.9% within 90 days of regimen initiation. Multivariable logistic regression indicated several negative predictors of HbA(1c) testing, including SFU use, age 65+ years, moderate insurance copayment and preindex inpatient utilisation. Multivariable logistic regression of variables associated with reduced likelihood of up-titration included TZD, SFU + MET, or TZD + MET treatment, age 18-34 years, Medicare insurance and any preindex healthcare utilisation.
conclusionsPatients are not being transitioned to additional OADs in a stepwise fashion and/or are receiving inadequate titration on current OAD regimens. The low rate of HbA(1c) testing and rates of control are contributing factors.
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