Endocrine Abstracts

Our objective was to estimate the distribution of Spanish diabetic patients attending to individualized glycaemic targets recommended by the ADA/EASD consensus with and without considering hypoglycaemia risk. We conducted a cross-sectional study in a Spanish primary care setting between 2011 and 2012. A total of 5382 type 2 diabetic subjects under antihyperglycaemic treatment for at least 3 months prior to inclusion completed a study visit in which clinical data including age, diabetes duration, complications and treatment, and presence of a hypoglycaemia during the last year were collected. A capillary HbA1c was measured by the A1CNow+ system. Patients were classified into different targets of HbA1c according to i) the ADA/EASD consensus without taking into account hypoglycaemia risk (presence of hypoglycaemia that required medical assistance during the past year and/or treatment with at least two insulin doses). ii) The ADA/EASD consensus taking into account hypoglycaemia risk. Mean HbA1c was 7.2 (1.2) % and 48.6% of our patients had an HbA1c <7%. According to the ADA/EASD strategy without taking into account hypoglycaemia risk, 15.9, 17.1 and 67% of the patients applied to glycaemic targets of <6.5, <7 and <8% and 67.4% of the patients were considered to have an adequate glycaemic control. On the other hand, according to the ADA/EASD strategy taking into account hypoglycaemia risk 14.9, 15.5 and 69.6% of the patients applied to glycaemic targets of <6.5, <7 and <8% and 68.5% were considered to have an adequate glycaemic control. The degree of concordance between both strategies in terms of classifying patients at a certain HbA1c target was 97.4% (κ coefficient=0.9413).

In conclusion, individualisation of glycaemic targets increases the proportion of patients considered adequately controlled. The inclusion of information regarding hypoglycaemia risk in the ADA/EASD strategy does not affect patient classification.