Endocrine Abstracts

Objective: To evaluate the evolution of glycemic control in a cohort of patients with type 2 diabetes mellitus (T2DM) after its assessment in endocrinology.

Methods: Prospective cohort study. 465 patients with T2DM who were not followed up at an endocrinology clinic were included. This study was approved by the Ethics and Clinical Research Committee of the University Hospital of Guadalajara.

Results: Mean age was 63.4±12.5 years; 61.5% males. Time of evolution of T2DM was <5 years in 30.1% of cases and ≧5 years in 69.9%. At the beginning of the study, 7.5% of patients did not receive hypoglycaemic treatment, 60.9% received oral antidiabetics (OA) (including glucagon-like peptide-1 receptor agonists), and 31.6% received insulin therapy (with or without OA). Initial body mass index was 33.2±7.4 kg/m² and at 26 weeks follow up was 32.4±6.8 kg/m² (P<0.0001). Initially, 1.3% of the patients presented some episode of severe hypoglycaemia in the year prior to their inclusion in the study, while after 26 weeks of follow-up, 1.4% of the patients presented some episode (P=0.7).

Evolution of glycated hemoglobin (HbA1c) according to the characteristics of the patients. Initial HbA1c; HbA1c at 26 weeks of follow up; Difference of means; 95%CI; p.

– Entire cohort: 8.3±1.8; 6.6±0.9; 1.7; 1.4–1.9; <0.0001

– Male: 8.4±1.7; 6.6±1; 1.8; 1.6–2.1; <0.0001

– Female: 7.9±1.9; 6.6±1; 1.3; 1–1.8; <0.0001

– <65 years: 8.6±1.9; 6.5±1.1; 2.1; 1.7–2.4; <0.0001

– ≥ 65 years: 7.9±1.6; 6.7±0.9; 1.2; 1–1.5; <0.0001

– <5 years of evolution of T2DM: 8.2±2.1; 6.2±0.8; 2; 1.5–2.5; <0.0001

– ≥5 years of evolution of T2DM: 8.3±1.7; 6.8±1; 1.5; 1.3–1.8; <0.0001

– Initial HbA1c ≥7%: 9.1±1.6; 6.8±1; 2.3; 2.1–2.6; <0.0001

– Initial HbA1c <7%: 6.4±0.4; 6.2±0.8; 0.2; −0.002–0.3; 0.098

– Initial treatment with OA; 8.1±1.8; 6.5±0.9; 1.6; 1.3–1.9; <0.0001

– Initial treatment with insulin: 8.7±1.8; 6.9±1.1; 1.7; 1.3–2.1; <0.0001

Conclusions: – There is an improvement in glycemic control without weight gain or increase of severe hypoglycaemia episodes.

– The improvement is independent of the characteristics of the patients, although it is not achieved in patients with initial HbA1c <7%.