Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus
BackgroundLong-term durable glycemic control is a difficult goal in the management of type 2 diabetes mellitus (T2DM). We evaluated the factors associated with durable glycemic control in a real clinical setting.MethodsWe retrospectively reviewed the medical records of 194 new-onset, drug-naïve pati...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Diabetes Association
2017-08-01
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| Series: | Diabetes & Metabolism Journal |
| Subjects: | |
| Online Access: | https://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-41-284.pdf |
| _version_ | 1830512926239227904 |
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| author | Kyoung Jin Kim Ju Hee Choi Kyeong Jin Kim Jee Hyun An Hee Young Kim Sin Gon Kim Nam Hoon Kim |
| author_facet | Kyoung Jin Kim Ju Hee Choi Kyeong Jin Kim Jee Hyun An Hee Young Kim Sin Gon Kim Nam Hoon Kim |
| author_sort | Kyoung Jin Kim |
| collection | DOAJ |
| description | BackgroundLong-term durable glycemic control is a difficult goal in the management of type 2 diabetes mellitus (T2DM). We evaluated the factors associated with durable glycemic control in a real clinical setting.MethodsWe retrospectively reviewed the medical records of 194 new-onset, drug-naïve patients with T2DM who were diagnosed between January 2011 and March 2013, and were followed up for >2 years. Glycemic durability was defined as the maintenance of optimal glycemic control (glycosylated hemoglobin [HbA1c] <7.0%) for 2 years without substitution or adding other glucose-lowering agents. Clinical factors and glycemic markers associated with glycemic durability were compared between two groups: a durability group and a non-durability group.ResultsPatients in the durability group had a higher baseline body mass index (26.1 kg/m2 vs. 24.9 kg/m2) and lower HbA1c (8.6% vs. 9.7%) than the non-durability group. The initial choice of glucose-lowering agents was similar in both groups, except for insulin and sulfonylureas, which were more frequently prescribed in the non-durability group. In multiple logistic regression analyses, higher levels of education, physical activity, and homeostasis model assessment of β-cell function (HOMA-β) were associated with glycemic durability. Notably, lower HbA1c (<7.0%) at baseline and first follow-up were significantly associated with glycemic durability (adjusted odds ratio [OR], 7.48; 95% confidence interval [CI], 2.51 to 22.3) (adjusted OR, 9.27; 95% CI, 1.62 to 53.1, respectively), after adjusting for confounding variables including the types of glucose-lowering agents.ConclusionEarly achievement of HbA1c level within the glycemic target was a determinant of long-term glycemic durability in new-onset T2DM, as were higher levels of education, physical activity, and HOMA-β. |
| first_indexed | 2024-12-22T02:35:25Z |
| format | Article |
| id | doaj.art-0ffa61108a2e4b4683642ec1c26860c0 |
| institution | Directory Open Access Journal |
| issn | 2233-6079 2233-6087 |
| language | English |
| last_indexed | 2024-12-22T02:35:25Z |
| publishDate | 2017-08-01 |
| publisher | Korean Diabetes Association |
| record_format | Article |
| series | Diabetes & Metabolism Journal |
| spelling | doaj.art-0ffa61108a2e4b4683642ec1c26860c02022-12-21T18:41:46ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872017-08-0141428429510.4093/dmj.2017.41.4.284Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes MellitusKyoung Jin KimJu Hee ChoiKyeong Jin KimJee Hyun AnHee Young KimSin Gon KimNam Hoon KimBackgroundLong-term durable glycemic control is a difficult goal in the management of type 2 diabetes mellitus (T2DM). We evaluated the factors associated with durable glycemic control in a real clinical setting.MethodsWe retrospectively reviewed the medical records of 194 new-onset, drug-naïve patients with T2DM who were diagnosed between January 2011 and March 2013, and were followed up for >2 years. Glycemic durability was defined as the maintenance of optimal glycemic control (glycosylated hemoglobin [HbA1c] <7.0%) for 2 years without substitution or adding other glucose-lowering agents. Clinical factors and glycemic markers associated with glycemic durability were compared between two groups: a durability group and a non-durability group.ResultsPatients in the durability group had a higher baseline body mass index (26.1 kg/m2 vs. 24.9 kg/m2) and lower HbA1c (8.6% vs. 9.7%) than the non-durability group. The initial choice of glucose-lowering agents was similar in both groups, except for insulin and sulfonylureas, which were more frequently prescribed in the non-durability group. In multiple logistic regression analyses, higher levels of education, physical activity, and homeostasis model assessment of β-cell function (HOMA-β) were associated with glycemic durability. Notably, lower HbA1c (<7.0%) at baseline and first follow-up were significantly associated with glycemic durability (adjusted odds ratio [OR], 7.48; 95% confidence interval [CI], 2.51 to 22.3) (adjusted OR, 9.27; 95% CI, 1.62 to 53.1, respectively), after adjusting for confounding variables including the types of glucose-lowering agents.ConclusionEarly achievement of HbA1c level within the glycemic target was a determinant of long-term glycemic durability in new-onset T2DM, as were higher levels of education, physical activity, and HOMA-β.https://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-41-284.pdfDiabetes mellitus, type 2DurabilityGlycemic control |
| spellingShingle | Kyoung Jin Kim Ju Hee Choi Kyeong Jin Kim Jee Hyun An Hee Young Kim Sin Gon Kim Nam Hoon Kim Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus Diabetes & Metabolism Journal Diabetes mellitus, type 2 Durability Glycemic control |
| title | Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus |
| title_full | Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus |
| title_fullStr | Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus |
| title_full_unstemmed | Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus |
| title_short | Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus |
| title_sort | determinants of long term durable glycemic control in new onset type 2 diabetes mellitus |
| topic | Diabetes mellitus, type 2 Durability Glycemic control |
| url | https://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-41-284.pdf |
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