Actual ambulatory care in patients with type 2 diabetes mellitus in Russian Federation according to open label prospectiveobservational study DIA-CONTROL

Abstract

This review presents a comprehensive analysis of actual ambulatory care in patients with type 2 diabetes mellitus provided in 10 federal subjects withinthe period of 1 year. The analysis is based on results from non-interventional open label prospective observational study DIA-CONTROL, whichincluded 9844 patients with DM type 2. The study was aimed to assess the initial level of glycated hemoglobin and its further dynamics according tomeasurements repeated every 3 months. Composition and efficiency of hypoglycemic therapy were also estimated in these patients.Inclusion visit showed 38.5% of patients to have adequate HbA_1c levels (<7%). 17% of patients were treatment, 41% remained on monotherapy,19% received combined treatment and 23% - insulin therapy (with or without oral hypoglycemic agents). Metformin and DPP-4 inhibitors,as well as their combination, were most common choices for initiation of treatment - with aforementioned combination (as more safe in respect ofhypoglycemic events) being preferred to traditional combination of metformin and sulphonylurea derivatives. Insulin therapy was actively prescribedin cases of inadequate glycemic control.Naturally, positive correlation was observed between HbA_1c levels and therapy correction frequency. However, more than 20% of physicians preservedthe therapeutic scheme unchanged in case of HbA_1c>8%, which is quite disturbing and suggests a more careful approach to instruction of healthcarespecialists.