Is newly diagnosed type 2 diabetes treated according to the guidelines? Results of the Polish ARETAEUS1 study.
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INTRODUCTION: There is a paucity of data on meeting treatment goals in patients with newly diagnosed type 2 diabetes (DM2). OBJECTIVES: The aim of the study was to characterize Polish patients with newly diagnosed DM2, to assess management of hyperglycemia, and to estimate the proportion of patients achieving the criteria of disease control recommended by the national clinical practice guidelines published in 2008. PATIENTS AND METHODS: ARETAEUS1 was a cross-sectional questionnaire-based study conducted in several regions of Poland in 2009 (January-April). It involved 1714 patients with DM2 of any age and sex, treated for less than 24 months, and recruited by randomly selected physicians. RESULTS: Only 28.9% of patients with DM2 met the goal for glycated hemoglobin (HbA1c) control (<6.5%). In the total population, only 1.4% of all patients met all 3 goals (HbA1c, blood pressure, and lipid levels), 12.5%--2 goals, and 35.3%--only 1 goal; 50.7% did not meet any of the treatment goals. Achieving all of the treatment goals varied between the patient subgroups (in relation to the current diabetes treatment, age, sex, body mass index, and diabetes duration). CONCLUSIONS: Most patients with newly diagnosed DM2 do not meet all their major treatment goals, which indicates relatively low adherence to the national guideline recommendations for diabetes control and primary cardiovascular prevention in DM2. Metformin seems to be underused and titration of other glucose lowering medications may be insufficiently target-driven. Assuming that adherence to the current clinical practice guidelines is beneficial for patients, we recommend that both practitioners and patients have increased awareness of these guidelines and of the ways to achieve and maintain treatment goals.
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