Type 2 diabetics followed up by family physicians: Treatment sequences and changes over time in weight and glycated hemoglobin

The treatment of type 2 diabetes mellitus (T2DM) is based on preventive hygiene and dietary measures (HDM), oral antidiabetic drugs (OADs), and insulin. The objective of the present study was to reuse general practice data from electronic health records and describe changes over time among patients...

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Bibliographic Details
Published in:Primary care diabetes 2022-10, Vol.16 (5), p.670-676
Main Authors: Boullenger, Léna, Quindroit, Paul, Legrand, Bertrand, Balcaen, Thibaut, Calafiore, Matthieu, Rochoy, Michaël, Beuscart, Jean-Baptiste, Chazard, Emmanuel
Format: Article
Language:English
Subjects:
Blood Glucose
Data reuse
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - drug therapy
Drug Therapy, Combination
Electronic health records
General practice
Glycated hemoglobin
Glycated Hemoglobin - analysis
Humans
Hypoglycemic Agents - adverse effects
Insulin - adverse effects
Life Sciences
Middle Aged
Physicians, Family
Type 2 diabetes mellitus
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Summary:The treatment of type 2 diabetes mellitus (T2DM) is based on preventive hygiene and dietary measures (HDM), oral antidiabetic drugs (OADs), and insulin. The objective of the present study was to reuse general practice data from electronic health records and describe changes over time among patients with T2DM in primary care. We analyzed data on patients with T2DM collected by three family physicians in Tourcoing (France) from 2006 to 2018. 403 patients, 1030 treatment sequences, 39,042 appointments, 2440 glycated hemoglobin (HbA1c) measurements, and 9722 wt measurements were included. On inclusion, the mean age was 57.0, the mean weight was 84.4 kg, the mean body mass index was 30.3 kg/m2, and the median HbA1c level was 6.8 % (51 mmol/mol). The patients were following appropriate HDM (40.7 %) and/or were being treated with OADs (54.1 %) or insulin (5.2 %). The median length of follow-up was 3.51 years. Overall, bodyweight was stable for two years during HDM and then increased. The HbA1c level decreased and then increased during HDM, was stable on OADs, and then decreased on insulin. The present descriptive results may be of value in helping to predict changes over time in bodyweight and HbA1c in T2DM. •We describe changes over time among patients with T2DM in primary care.•A large cohort of patients with T2DM collected by three family physicians from 2006 to 2018 were included.•The patients were following appropriate dietary rules and/or were being treated with oral antidiabetic drugs or insulin.•This work provides clinicians with useful aggregate indicators of the course of T2DM in real life.•It illustrates the great potential of secondary use of data from electronic health records in general practice.
ISSN:1751-9918
1878-0210
1878-0210
DOI:10.1016/j.pcd.2022.07.002