Endocrine Abstracts

Methods: We studied 228 patients with T2DM treated in Pauls Stradins Clinical University Hospital in Endocrinology Department from Jan 2013 to Sep 2014. The greatest attention was paid to the patients’ biochemical analyses, such as triglycerides (TG), c-peptide, HbA1c and prescribed treatment, as well as BMI and the doctor who treated each patient. Phenotypically patients were divided into four major groups. The first group included 73 patients with chronic kidney disease (GFR <60 ml/min per 1.73 m²), the second – 31 patient with obesity (BMI >30 kg/m²), 66 persons represented older patients group (>65 years old) and 58 – with early diabetes (<10 years).

Results: For patients with obesity, treatment was started with insulin and metformin combination; chronic kidney disease group – with insulin monotherapy; in groups of old patients (>65 years) and early diabetes patients – with insulin monotherapy. Insulin monotherapy was used for patients with c-peptide 0.1–0.9 ng/l; for patients with c-peptide 1–2 ng/ml was used metformin combination with insulin, but patients with c-peptide more than 2 ng/ml were treated more often with DPP-4/metformin combination with insulin. There was no correlation between HbA1c level and prescribed therapy. For patients with TG level from 1.7 to 5.6 mmol/l was used metformin together with insulin, with TG <1.7 mmol/l – only insulin, but with TG over 5.7 mmol/l DPP-4/metformin combination with insulin. We found some correlation between prescribed therapy and treating physicians: three of five physicians treated their patients more often with insulin. One treated patients mostly with combination of insulin and metformin, while last – with combination of DPP-4/metformin and insulin.

Conclusion: As T2DM is a special medical condition that requires an individualised approach to each patient to achieve adequate glycaemia and HbA1c levels.