Article Sidebar
Views PDF: 423
GLYCEMIC CONTROL IN OUTPATIENT MANAGEMENT OF TYPE 2 DIABETES AT NHAN DAN GIA DINH HOSPITAL: A CROSS-SECTIONAL STUDY
Main Article Content
Abstract
Introduction: Type 2 diabetes mellitus is a common risk factor for cardiovascular disease in Vietnam. Glycemic control is a crucial goal and has been demonstrated to prevent microvascular complications, although its benefits in macrovascular complications remain unclear. Hypoglycemic agents have shown cardiovascular benefits. Objectives: This study aimed to determine the rate of glycemic control and the utilization of hypoglycemic agents with cardiovascular benefits in outpatient management of patients with type 2 diabetes. Methods: A cross-sectional descriptive study was conducted at the endocrinology and cardiology clinics of Nhan dan Gia Dinh hospital from March 2021 to March 2022. Results: A total of 454 type 2 diabetic patients with a high to very high cardiovascular risk participated in the study. The prevalence of coronary artery disease, including stable angina and peripheral artery disease, was 38.5% and 0.4%, respectively. Heart failure prevalence was 2.4% and chronic kidney disease prevalence was 8.1%. The rate of glycemic control (HbA1C < 7%) was 54.8%. The most commonly prescribed hypoglycemic agents were metformin (76.9%) and sulfonylureas (49.3%). GLP-1 receptor agonists were not prescribed and SGLT2 inhibitors were indicated in only 1.1% of cases. Conclusions: Glycemic control remains suboptimal and the prescription of hypoglycemic agents with cardiovascular benefits is underutilized in type 2 diabetes. Therefore, there is a need for improved glycemic control and appropriate selection of hypoglycemic agents for this high-risk group.
Article Details
References
2. Abdul-Ghani M, DeFronzo RA, Del Prato S, Chilton R, Singh R, Ryder REJ. Cardiovascular Disease and Type 2 Diabetes: Has the Dawn of a New Era Arrived? Diabetes Care. 2017 Jul; 40(7):813-820.
3. Nelson AJ, Pagidipati NJ, Aroda VR, Cavender MA, Green JB, Lopes RD, Al-Khalidi H, Gaynor T, Kaltenbach LA, Kirk JK, Lingvay I, Magwire ML, O'Brien EC, Pak J, Pop-Busui R, Richardson CR, Reed M, Senyucel C, Webb L, McGuire DK, Granger CB. Incorporating SGLT2i and GLP-1RA for Cardiovascular and Kidney Disease Risk Reduction: Call for Action to the Cardiology Community. Circulation. 2021 Jul 6;144(1):74-84.
4. Presley CA, Khodneva Y, Juarez LD, Howell CR, Agne AA, Riggs KR, et al. Trends and Predictors of Glycemic Control Among Adults With Type 2 Diabetes Covered by Alabama Medicaid, 2011–2019. Prev Chronic Dis 2023;20:220332.
5. Bộ Y tế. Hướng dẫn chẩn đoán và điều trị đái tháo đường típ 2 (Ban hành kèm theo Quyết định số 5481/QĐ-BYT ngày 30 tháng 12 năm 2020). https://daithaoduong.kcb.vn/huong-dan-chan-doan-va-dieu-tri-dai-thao-duong-tip-2
6. Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, Federici M, Filippatos G, Grobbee DE, Hansen TB, Huikuri HV, Johansson I, Jüni P, Lettino M, Marx N, Mellbin LG, Östgren CJ, Rocca B, Roffi M, Sattar N, Seferović PM, Sousa-Uva M, Valensi P, Wheeler DC; ESC Scientific Document Group. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020 Jan 7;41(2):255-323.
7. Buse JB, Wexler DJ, Tsapas A, Rossing P, Mingrone G, Mathieu C, D'Alessio DA, Davies MJ. 2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2020 Feb;43(2):487-493.
8. Al Slail FY, Abid O, Assiri AM, Memish ZA, Ali MK. Cardiovascular risk profiles of adults with type-2 diabetes treated at urban hospitals in Riyadh, Saudi Arabia. J Epidemiol Glob Health. 2016 Mar;6(1):29-36.
9. Regassa LD, Tola A, Ayele Y. Prevalence of Cardiovascular Disease and Associated Factors Among Type 2 Diabetes Patients in Selected Hospitals of Harari Region, Eastern Ethiopia. Front Public Health. 2021 Feb 5;8:532719.
10. Sattar N, Lee MMY, Kristensen SL, Branch KRH, Del Prato S, Khurmi NS, Lam CSP, Lopes RD, McMurray JJV, Pratley RE, Rosenstock J, Gerstein HC. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials. Lancet Diabetes Endocrinol. 2021 Oct; 9(10):653-662.