Time to Treatment Intensification to Reduce Diabetes-Related Complications: A Post Hoc Study
Patients with type 2 diabetes mellitus (T2DM) can be affected by clinical inertia, leading to abysmal results. Studies on a suitable timeframe for treatment intensification remain scarce—especially outside of developed countries. This study aimed to explore the association between time to treatment...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-09-01
|
| Series: | Healthcare |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9032/10/9/1673 |
| _version_ | 1797487816189411328 |
|---|---|
| author | Piranee Kaewbut Natapong Kosachunhanun Arintaya Phrommintikul Dujrudee Chinwong John J. Hall Surarong Chinwong |
| author_facet | Piranee Kaewbut Natapong Kosachunhanun Arintaya Phrommintikul Dujrudee Chinwong John J. Hall Surarong Chinwong |
| author_sort | Piranee Kaewbut |
| collection | DOAJ |
| description | Patients with type 2 diabetes mellitus (T2DM) can be affected by clinical inertia, leading to abysmal results. Studies on a suitable timeframe for treatment intensification remain scarce—especially outside of developed countries. This study aimed to explore the association between time to treatment intensification and diabetes-related complications. A database from a tertiary care hospital in Thailand was retrieved in order to conduct a retrospective cohort study for the years 2011–2017. This study comprised outpatients with T2DM presenting an HbA1c of ≥7.0%. Eligible patients were divided into three groups based on the time of treatment intensification: no delayed treatment intensification, treatment intensification within 6 months, and treatment intensification after 6 months. A Cox proportional hazards model was used to investigate the association between time to treatment intensification and diabetes-related complications. A total of 686 patients were included in the final analysis. During 6.5 years of median follow-up, the group with treatment intensification within 6 months was more strongly associated with diabetic nephropathy compared to the group with no delayed treatment intensification (adjusted HR 2.35; 95%CI 1.35–4.09). Our findings reveal that delaying treatment intensification by even 6 months can increase the likelihood of diabetic nephropathy compared to no delayed treatment intensification. We suggest that patients with T2DM whose blood glucose levels are outside the target range promptly receive treatment intensification. |
| first_indexed | 2024-03-09T23:53:11Z |
| format | Article |
| id | doaj.art-08d30f9b226345299bee0951b58ccbc1 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-09T23:53:11Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-08d30f9b226345299bee0951b58ccbc12023-11-23T16:28:51ZengMDPI AGHealthcare2227-90322022-09-01109167310.3390/healthcare10091673Time to Treatment Intensification to Reduce Diabetes-Related Complications: A Post Hoc StudyPiranee Kaewbut0Natapong Kosachunhanun1Arintaya Phrommintikul2Dujrudee Chinwong3John J. Hall4Surarong Chinwong5PhD’s Degree Program in Pharmacy, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, ThailandSchool of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, AustraliaDepartment of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, ThailandPatients with type 2 diabetes mellitus (T2DM) can be affected by clinical inertia, leading to abysmal results. Studies on a suitable timeframe for treatment intensification remain scarce—especially outside of developed countries. This study aimed to explore the association between time to treatment intensification and diabetes-related complications. A database from a tertiary care hospital in Thailand was retrieved in order to conduct a retrospective cohort study for the years 2011–2017. This study comprised outpatients with T2DM presenting an HbA1c of ≥7.0%. Eligible patients were divided into three groups based on the time of treatment intensification: no delayed treatment intensification, treatment intensification within 6 months, and treatment intensification after 6 months. A Cox proportional hazards model was used to investigate the association between time to treatment intensification and diabetes-related complications. A total of 686 patients were included in the final analysis. During 6.5 years of median follow-up, the group with treatment intensification within 6 months was more strongly associated with diabetic nephropathy compared to the group with no delayed treatment intensification (adjusted HR 2.35; 95%CI 1.35–4.09). Our findings reveal that delaying treatment intensification by even 6 months can increase the likelihood of diabetic nephropathy compared to no delayed treatment intensification. We suggest that patients with T2DM whose blood glucose levels are outside the target range promptly receive treatment intensification.https://www.mdpi.com/2227-9032/10/9/1673clinical inertiatherapeutic inertiatime to treatment intensificationdiabetes-related complicationsdiabetic nephropathy |
| spellingShingle | Piranee Kaewbut Natapong Kosachunhanun Arintaya Phrommintikul Dujrudee Chinwong John J. Hall Surarong Chinwong Time to Treatment Intensification to Reduce Diabetes-Related Complications: A Post Hoc Study Healthcare clinical inertia therapeutic inertia time to treatment intensification diabetes-related complications diabetic nephropathy |
| title | Time to Treatment Intensification to Reduce Diabetes-Related Complications: A Post Hoc Study |
| title_full | Time to Treatment Intensification to Reduce Diabetes-Related Complications: A Post Hoc Study |
| title_fullStr | Time to Treatment Intensification to Reduce Diabetes-Related Complications: A Post Hoc Study |
| title_full_unstemmed | Time to Treatment Intensification to Reduce Diabetes-Related Complications: A Post Hoc Study |
| title_short | Time to Treatment Intensification to Reduce Diabetes-Related Complications: A Post Hoc Study |
| title_sort | time to treatment intensification to reduce diabetes related complications a post hoc study |
| topic | clinical inertia therapeutic inertia time to treatment intensification diabetes-related complications diabetic nephropathy |
| url | https://www.mdpi.com/2227-9032/10/9/1673 |
| work_keys_str_mv | AT piraneekaewbut timetotreatmentintensificationtoreducediabetesrelatedcomplicationsaposthocstudy AT natapongkosachunhanun timetotreatmentintensificationtoreducediabetesrelatedcomplicationsaposthocstudy AT arintayaphrommintikul timetotreatmentintensificationtoreducediabetesrelatedcomplicationsaposthocstudy AT dujrudeechinwong timetotreatmentintensificationtoreducediabetesrelatedcomplicationsaposthocstudy AT johnjhall timetotreatmentintensificationtoreducediabetesrelatedcomplicationsaposthocstudy AT surarongchinwong timetotreatmentintensificationtoreducediabetesrelatedcomplicationsaposthocstudy |