Type 2 diabetes treatment intensification in general practice in France in 2008–2009: the DIAttitude Study

Abstract Aims To evaluate the current procedures in French general practice of intensifying hypoglycaemic treatment in orally treated type 2 diabetic patients, according to the French recommendations. Methods Type 2 diabetic patient characteristics, HbA1c values, hypoglycaemic treatment and physicia...

Full description

Saved in:
Bibliographic Details
Published in:Diabetes & metabolism 2012-03, Vol.38, p.S29-S35
Main Authors: Balkau, B, Bouée, S, Avignon, A, Vergès, B, Chartier, I, Amelineau, E, Halimi, S
Format: Article
Language:English
Subjects:
Administration, Oral
Aged
Aged, 80 and over
Attitude of Health Personnel
Blood Glucose - metabolism
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - epidemiology
Diabète du type 2
Drug Administration Schedule
Endocrinology & Metabolism
Female
France
France - epidemiology
General Practice - standards
General Practice - statistics & numerical data
Glycated Hemoglobin A - metabolism
Guideline Adherence
Humans
Hypoglycemic Agents - administration & dosage
Inertie thérapeutique
Insulin - administration & dosage
Internal Medicine
Male
Middle Aged
Médecine générale
Primary care
Review
Revue générale
Therapeutic inertia
Traitement
Treatment
Type 2 diabetes
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Aims To evaluate the current procedures in French general practice of intensifying hypoglycaemic treatment in orally treated type 2 diabetic patients, according to the French recommendations. Methods Type 2 diabetic patient characteristics, HbA1c values, hypoglycaemic treatment and physician characteristics were collected from the electronic records of a panel of French general practitioners. Factors associated with the time until intensification of treatment were studied with the Cox model. Results Among 17 493 orally treated patients with at least two available HbA1c values, 3118 patients (18%) required treatment intensification; 65% were on monotherapy, 31% on bitherapy and 4% on tritherapy. These patients were followed for a maximum of 14 months or until treatment was intensified. Treatment was intensified after the second high HbA1c value for 1212 patients (39%); this was immediate for 13% of these patients, within 6 months for 39% and within one year for 59%. Treatment intensification was less likely the older the patient, and more likely the higher the first HbA1c value, up to an HbA1c threshold of 9%. Conclusions Therapeutic inertia in caring for type 2 diabetic patients in France is frequent, at least for patients treated in general practice. This inadequate glycaemic control would be expected to have significant patient and public health consequences, with higher rates of associated diabetic complications.
ISSN:1262-3636
1878-1780
DOI:10.1016/S1262-3636(12)71532-X