Achieving triple treatment goals in multi-ethnic Asian patients with type 2 diabetes mellitus in primary care
- Author:
Goh Chin Chin
;
Kim Hwee Koh
;
Soo Chye Paul Goh,
;
Yi Ling Eileen Koh
;
Ngiap Chuan Tan
- Publication Type:Journal Article
- Keywords:
Type 2 diabetes mellitus;
normoglycemia;
blood pressure;
LDL-Cholesterol;
treatment goals
- From:Malaysian Family Physician
2018;13(2):10-18
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Achieving optimal glycated hemoglobin (HbA1c), blood pressure (BP), and LDLCholesterol (LDL-C) in patients mitigates macro- and micro-vascular complications, which is the
key treatment goal in managing type 2 diabetes mellitus (T2DM). This study aimed to determine
the proportion of patients in an urban community with T2DM and the above modifiable
conditions attaining triple vascular treatment goals based on current practice guidelines.
Methods: A questionnaire was distributed to adult Asian patients with dyslipidemia at two primary
care clinics (polyclinics) in northeastern Singapore. The demographic and clinical data for this
sub-population with both T2DM and dyslipidemia were collated with laboratory and treatment
information retrieved from their electronic health records. The combined data was then analyzed
to determine the proportion of patients who attained triple treatment goals, and logistic regression
analysis was used to identify factors associated with this outcome.
Results: 665 eligible patients [60.5% female, 30.5% Chinese, 35% Malays, and 34.4% Indians]
with a mean age of 60.6 years were recruited. Of these patients, 71% achieved LDL-C ≤2.6
mmol/L, 70.4% had BP <140/90 mmHg, and 40.9% attained HbA1c ≤7%. Overall, 22%
achieved the triple treatment goals for glycemia, BP, and LDL-C control. The major determinants
were the number of diabetic medications and intensity of statin therapy.
Conclusion: Eight in ten patients with T2DM failed to achieve concurrent glycemic, BP, and
LDL-C treatment goals, subjecting them to risks of vascular complications. Primary healthcare
professionals can mitigate these risks by optimizing therapeutic treatment to maximize glycemia,
dyslipidemia, and BP control.
- Full text:2.2018my0003.pdf
