| Abstract [eng] |
Introduction. Diabetes mellitus (DM) is a chronic, multifactorial disease that requires personalised care to manage the disease in a timely and appropriate manner and to prevent complications. The aim. To identify indications for changes in the treatment of patients with diabetes Objectives. 1. To determine the characteristics of disease control in patients with diabetes. 2. To assess the incidence of comorbid cardiovascular disease and chronic kidney disease in people with diabetes. 3. Identify the most common reasons for treatment switching. Methodology. A prospective observational study was conducted to examine demographic, disease control and medication use data of patients participating in the biomedical study "Associations between patient-centred care, treatment engagement and disease control in patients with diabetes with multimorbidity". The significance level chosen for testing statistical hypothseses was p=0,05. Results. Data from 187 patients were analysed, 56.1% of the participants were women. The average age of the patients was 58.7±10.7 years. Women were significantly 3.57 years older than men (p=0.0284), 58.3% of the subjects were aged 50-65 years: 56.1% were men and 60% were women (p=0.8). 170 patients (90.9%) had type 2 diabetes mellitus (T2DM). The mean duration of diabetes was 10.56±8.13 years. HbA1c and BMI were measured to assess DM control. In 58% of the patients, diabetes control was within target limits. The mean HbA1c value was 6.98±1.23%. There was a weak inverse relationship between HbA1c and age (r=-0.251, p<0.01), and a weak direct relationship between HbA1c and duration of diabetes (r=0.293, p<0.01). The mean body mass index (BMI) of the subjects was 32.4±6.3 kg/m², 64.2% of the subjects were obese (p<0.001). 133 (71.1%) subjects had 1 to 3 microvascular complications of diabetes. 53 (28.3%) had a history of cardiovascular disease (CVD) and/or risk factors for CVD and/or chronic kidney disease (CKD): 18 (9.6%) had a history of myocardial infarction and/or stroke, 43 (23%) were aged 55 or older and had risk factors for CVD, 3 (1.6%) had a history of heart failure, 14 (7.5%) had a history of diabetes mellitus and 3 (2.6%) had a history of stroke. The most common reasons for changing diabetes treatment in this sample were a history of CVD and/or risk factors for CVD and/or CVD in 36 (19.3%) patients, poor diabetes control in 31 (16.6%) patients, or a combination of the two in 21 (11.2%) patients. In 4 patients, treatment was altered due to hypoglycaemia and in 2 patients due to adverse events. Conclusions. More than half of the patients had an HbA1c within the target range at their first visit. More than a quarter of patients had CKD and/or risk factors for these diseases and/or CVD. The most common reasons for changing diabetes treatment in this sample were a history of CKD and/or risk factors for these diseases and/or CVD and poor diabetes control, or a combination of both. |
