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Revista Clínica de Medicina de Familia
On-line version ISSN 2386-8201Print version ISSN 1699-695X
Abstract
DOMINGUEZ SANCHEZ-MIGALLON, Pedro. Changes in metabolic control and in antidiabetic drug use in type-2 diabetic patients in a Primary Care center. Rev Clin Med Fam [online]. 2020, vol.13, n.1, pp.22-31. Epub Apr 20, 2020. ISSN 2386-8201.
Objective:
To determine the changes produced during a period of four years and a period of nine years in the control of diabetic patients and in drug use in usual practice.
Design:
Observational, descriptive, cross-sectional study.
Location:
Manzanares II Healthcare Area.
Participants:
Diabetic patients of either sex from the Health Area.
Main measures:
We collected sociodemographic data, cardiovascular risk factors, macro and microvascular complications of diabetes, analytical test findings (carbohydrates, lipids), and blood pressure, as well as drugs used for the treatment of diabetes, dyslipidemia, and antiplatelets/anticoagulants. The data were compared with the findings of the observational studies conducted in 2010 and 2014.
Results:
Metabolic control (HbA1c) has improved in 2019 (6.87 ± 0.99) in comparison with 2014: 7.09 % (± 1.17) and 2010: 7.22 % (±1.21), with a significant decrease in the percentage of HbA1c (≥ 8 % y ≥ 10 %). The percentage of HbA1c ≤ 7% has grown from 50.5 % (2010) and 53.7% (2014) to 61.3 % (2019), (p<0.05). The highest decreases have taken place in lipid levels: total cholesterol (p<0.001), LDL-cholesterol (p<0.001). The percentage of HbA1c ≤ 7% and LDL-cholesterol ≤ 100mg/dl has increased from 13.1 % (2010) and 21.7% (2014) to 36.5 % (2019) (p<0.001). There has been a decrease in the use of sulfonylureas and glinides (p<0.01) and an increase in the use of SGLT2 inhibitors and GLP-1 receptor antagonists (p<0.001), statins (p<0.01), acetylsalicylic acid (p<0.01), and novel oral anticoagulants (NOACs) (p<0.01)..
Conclusions:
Carbohydrate metabolic control has significantly improved during the nine-year period, with greatest improvement in lipid profiles. The use of sulfonylureas and glinides has decreased, whereas the use of SGLT2 inhibitors, CLP-1 receptor antagonists, statins, acetylsalicylic acid, and NOACs has increased.
Keywords : Diabetes Mellitus; Antidiabetic drugs; Noninsulin antidiabetic drugs; Primary care.