Highlights
- •A personalised approach for treatment targets in type 2 diabetes is proposed.
- •Personalising diabetes treatment targets should be simple and practical.
- •Our approach could lead to more cardiometabolic well-controlled patients.
- •Older patients and in those with polypharmacy could benefit most.
Abstract
Aims
To compare the proportion of cardiometabolic well-controlled type 2 diabetes mellitus
(T2DM) patients according to a clearly defined, simple personalised approach, versus
the ‘one-size-fits-all’ approach.
Methods
Observational study using routine data of primary care type 2 diabetes patients in
the Netherlands. The proportions of patients that reach the targets for HbA1c, systolic
blood pressure and low-density lipoprotein cholesterol in the two different approaches
were compared.
Results
Of the 890 patients (54.7% men, mean age 62.7 years), 31.8% were well-controlled according
to the individualised approach and 24.8% according to the ‘one-size-fits-all’ approach.
For specific subgroups personalising the treatment led to a 5.2%, 27.3% and 45.6%
increase of patients achieving low-density lipoprotein cholesterol, HbA1c and systolic
blood pressure goals respectively.
Conclusions
A clearly defined and relatively simple personalised approach leads to a higher proportion
of T2DM patients considered as cardiometabolic well-controlled. This approach may
especially be beneficial for patients aged ≥70 years on more than metformin monotherapy
(HbA1c) and for patients aged ≥80 years (SBP). Precisely these patients are suggested
not to benefit from stricter HbA1c or SBP targets, whereas they may experience more
adverse effects (e.g. hypoglycaemia, postural hypotension) when a stricter target
value is pursued.
Keywords
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Article info
Publication history
Published online: September 13, 2016
Accepted:
August 2,
2016
Received in revised form:
May 23,
2016
Received:
February 17,
2016
Identification
Copyright
© 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
