Significance of HbA1c targets based on an individual approach to the treatment of patients with type 2 diabetes mellitus

Background.
Over the past few years, special attention has been paid to achieving glycaemic control for type 2 diabetes mellitus (T2DM) patients, since it is a factor for determining the risk of developing macro- and microvascular complications of diabetes. Certain modern guidelines suggest an individual approach to the choice of HbA_1c target.
Objective.
Objective.
 .
of this study was to estimate the percentage of T2DM patients who have reached the HbA_1c levels. This was determined based on their age and the presence of severe complications.
Materials and Methods.
A total of 2195 patients with T2DM were studied. The patients were divided into the following age groups: <45, 45?64, and over 65 years. Each group was subdivided into two subgroups depending on the presence of severe complications. The target level of HbA_1c was determined according to the subjects? age and the presence of severe complications:.

• <45 years old without complications ? HbA_1c<6.5%;
• <45 years old with complications and 45?64 years old without complications ? HbA_1c<7.0%;
• 45?64 years old with complications and over 65 years old without complications ? HbA_1c<7.5%;
• over 65 years old with complications ? HbA_1c<8%.

Statistical analyses were performed using Microsoft Excel. The data are presented as mean values ? standard deviation.
Results.
The following glucose-lowering therapy techniques were used for different groups: monotherapy with diet ? 301 (13.7%) patients; oral antidiabetic drugs (OADs) ? 1335 (60.8%) patients; combined treatment using OADs with insulin ? 319 (14.6%) patients; and insulin monotherapy ? 240 (10.9%) patients. The HbA_1c target was reached for 27.3% of patients in the group aged <45 years old without complications; in the group < 45 years old with complications for 25.0% of patients; in the group of 45?64 years old without complications for 30.0% of patients; in the group aged 45?64 with complications for 35.2% of patients; in the group?65 years old without complications for 43% of patients, and in the group?65 years old with complications for 55.6% of patients.
Conclusions.
The proportion of T2DM patients who have reached the HbA_1c target value using the individual approach was higher than that using the conventional approach (HbA_1c<7.0%). A high percentage of patients did not achieve HbA_1c targets in all groups, indicating the need for antihyperglycaemic therapy.

type 2 diabetes mellitus, individual approach, HbA1c targets

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