Document Detail


Polypharmacy with oral antidiabetic agents: an indicator of poor glycemic control.
MedLine Citation:
PMID:  16886886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate antidiabetic drug treatment patterns and glycemic control among patients diagnosed with type 2 diabetes mellitus. STUDY DESIGN: Retrospective study using the automated databases of a 200 000-member HMO. METHODS: The study population consisted of patients > or =18 years of age with documented type 2 diabetes mellitus from January 1, 2002, through December 31, 2002. We determined the proportion of patients who had optimal glycemic control (glycosylated hemoglobin <7%) during the 6 months after the initial documentation of diabetes during calendar year 2002 (index date). RESULTS: Of the 4282 patients who met the inclusion criteria, 1050 (25%) received 1 oral agent, 486 (11%) received 2 oral agents, 56 (1%) received > or =3 oral agents, 84 (2%) received insulin and an oral agent, and 107 (2%) received insulin exclusively within 90 days after the index date. Among the 1075 patients receiving antidiabetic drug therapy who had a laboratory test result documented, 414 (39%) had optimal glycemic control. Optimal control was most frequent among patients receiving 1 oral agent (47%) and least frequent among patients receiving > or =3 oral agents (13%) (P <.01). Patients with a prior history of suboptimal glycemic control were less likely to have optimal glycemic control. CONCLUSIONS: Multiple oral antidiabetic agents may serve as a marker for more severe, uncontrolled diabetes. The vast majority of patients treated with multiple oral antidiabetic agents had suboptimal glycemic control, suggesting a need for intensified efforts to treat this particular group of patients to recommended goal levels.
Authors:
Cynthia J Willey; Susan E Andrade; Joseph Cohen; Jackie C Fuller; Jerry H Gurwitz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of managed care     Volume:  12     ISSN:  1088-0224     ISO Abbreviation:  Am J Manag Care     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-04     Completed Date:  2006-09-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9613960     Medline TA:  Am J Manag Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  435-40     Citation Subset:  H    
Affiliation:
Meyers Primary Care Institute, 630 Plantation Street, Worcester, MA 01605, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adolescent
Adult
Aged
Blood Glucose / analysis,  drug effects
Diabetes Mellitus, Type 2 / drug therapy*
Female
Health Maintenance Organizations
Humans
Hypoglycemic Agents / administration & dosage,  therapeutic use*
Male
Middle Aged
New England
Polypharmacy*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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