Therapy Escalation Following an Elevated HbA1c in Adults Aged 45 Years and Older Living With Diabetes in Australia: A Real-World Observational Analysis
| Autor: | Ji Hu, Kris Rogers, Ying Xie, Carinna Hockham, Meg Jardine, David Peiris, Sophia Zoungas, Tamara Young, Anna Campain, Louisa Sukkar, Jannah Baker, Alan Cass, Carol A. Pollock, Amy Kang, Min Jun, Germaine Wong |
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| Rok vydání: | 2020 |
| Předmět: |
Advanced and Specialized Nursing
medicine.medical_specialty education.field_of_study business.industry Endocrinology Diabetes and Metabolism Population Health services research Psychological intervention 030209 endocrinology & metabolism Pharmaceutical Benefits Scheme Type 2 diabetes medicine.disease 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine chemistry Diabetes mellitus Emergency medicine Internal Medicine Medicine 030212 general & internal medicine Glycated hemoglobin Medical prescription business education |
| Zdroj: | Diabetes Care. 43:e185-e187 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc20-0269 |
| Popis: | Stepwise escalation of glucose-lowering therapy to more intensive regimens is an integral component of type 2 diabetes management (1). Early blood glucose control is associated with beneficial effects on long-term micro- and macrovascular outcomes (2). Understanding factors associated with time to therapy escalation following an elevated glycated hemoglobin (HbA1c) may inform interventions to facilitate timely control. We used linked real-world data to examine time to therapy escalation following a recorded HbA1c ≥8.0% (64 mmol/mol) and associated factors. The EXamining ouTcomEs in chroNic Disease in the 45 and Up Study (EXTEND45 Study) is an Australian population-based linked data study in which participants of the 45 and Up Study have been linked to the Medicare Benefits Schedule (MBS), providing data on government-subsidized medical services, the Pharmaceutical Benefits Scheme (PBS), providing prescription claims data, and community laboratory databases (among others) (3). The 45 and Up Study comprises 267,153 individuals aged ≥45 years living in New South Wales (NSW), Australia, recruited between July 2006 and December 2009. Ethical approval for the EXTEND45 Study was obtained from the NSW Population & Health Services Research Ethics Committee (HREC/13/CIPHS/49). In EXTEND45, 24,430 individuals with diabetes between 2006 and 2014 have been identified using multiple linked data sources (3). In the current study, therapy escalation was assessed during the 6 months following all linked HbA1c results ≥8.0% occurring in non–treatment-naive, non–insulin-using individuals presumed to have type 2 diabetes. As a result, the unit of analysis was the elevated HbA1c, with individuals able to contribute multiple results to the analysis. A threshold of 8.0% was used to reflect the typically higher HbA1c targets recommended for older people (4). To ensure that all included HbA1c results represented separate instances of an elevated HbA1c in the same individual, those results ≥8.0% that occurred … |
| Databáze: | OpenAIRE |
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