Inadequate glycaemic control and antidiabetic therapy among inpatients with type 2 diabetes in Guangdong Province of China
Bi, Y.; Yan, J-hua.; Liao, Z-hong.; Li, Y-bing.; Zeng, L-yi.; Tang, K-xiao.; Xue, Y-ming.; Yang, H-zhang.; Li, L.; Cai, D-hong.; Wu, G.; Zhang, F.; Lin, S-da.; Xiao, Z-hua.; Zhu, D-long.; Weng, J-ping.
Chinese Medical Journal 121(8): 677-681
2008
ISSN/ISBN: 0366-6999 PMID: 18701017 Document Number: 625671
Background Diabetes mellitus has become epidemic in recent years in China. We investigated the prevalence of hyperglycaemia and inadequate glycaemic control among type 2 diabetic inpatients from ten university teaching hospitals in Guangdong Province, China.Methods Inadequate glycaemic control in diabetic patients was defined as HbA1c >= 6.5%. Therapeutic regimens included no-intervention, lifestyle only, oral antiglycemic agents (OA), insulin plus OA (insulin+OA), or insulin only. Antidiabetic managements included monotherapy, double therapy, triple or quadruple therapy.Results Among 493 diabetic inpatients with known history, 75% had HbA1c >= 6.5%. Inadequate glucose control rates were more frequently seen in patients on insulin+OA regimen (97%),than on OA regimen (71%) (P < 0.001), and more frequent in patients on combination therapy (81%-96%) than monotherapy (75%) (P < 0.05). Patients on insulin differed significantly from patients on OA by mean HbA1c, glycemic control rate, diabetes duration, microvascular complications, and BMI (P < 0.01).Conclusions This study showed that glycaemic control of type 2 diabetic patients deteriorated for patients who received insulin and initiation time of insulin was usually delayed. It is up to clinicians to move from the traditional stepwise therapy to a more active and early combination antidiabetic therapy to provide better glucose control.