The management of people with type 2 diabetes with multiple oral hypoglycaemic agents or insulin in primary care: retrospective cohort study

Melanie Calvert, Richard McManus, Nick Freemantle

Research output: Contribution to journalArticle

130 Citations (Scopus)

Abstract

BACKGROUND: Intensive glycaemic control can reduce the risk of microvascular complications in people with type 2 diabetes. AIM: To examine the extent of monitoring and glycaemic control of patients with type 2 diabetes prescribed oral agents and/or insulin, and to investigate transition to insulin. DESIGN OF STUDY: Retrospective cohort study. SETTING: A total of 154 general practices in the UK contributing to the DIN-LINK database between 1995 and 2005. METHOD: People with type 2 diabetes were identified using Read codes and prescribing data. Outcome measures were: glycaemic monitoring and control on multiple oral agents and/or insulin, and transition to insulin. RESULTS: A total of 14 824 people with type 2 diabetes were prescribed multiple oral agents concurrently, of whom 5064 (34.16%) had haemoglobin A(1c) (HbA(1c)) assessments 6 months before and following initiation of their last oral therapy. Mean HbA(1c) before therapy was 9.07%, which dropped to 8.16% following therapy (mean difference 0.91%, 95% confidence interval [CI] = 0.86 to 0.95, P or =7.5%. CONCLUSION: Many people with type 2 diabetes received inadequate monitoring and had poor glycaemic control. Intensive management is required to reduce the risk of microvascular complications.
Original languageEnglish
Pages (from-to)455-460
Number of pages6
JournalBritish Journal of General Practice
Volume57
Issue number539
Publication statusPublished - 1 Jul 2007

Keywords

  • diabetes mellitus
  • primary health care
  • drug therapy
  • type 2

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