Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study

Autor: Bruno Vergès, D. Simon, Y. Briand, C. Attali, Bruno Detournay, N. Grandfils, Olivier Delaitre, D. Joly, M. Toussi
Přispěvatelé: HAL UPMC, Gestionnaire, IMS Health [Puteaux], CEMKA-EVAL, Médecin généraliste, Département de Néphrologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Diabétologie [CHU Pitié-Salpétrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Boehringer Ingelheim, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de diabétologie [CHU Pitié-Salpétrière]
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Pediatrics
medicine.medical_specialty
Article Subject
Cross-sectional study
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
030232 urology & nephrology
030209 endocrinology & metabolism
Disease
urologic and male genital diseases
lcsh:Diseases of the endocrine glands. Clinical endocrinology
[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
03 medical and health sciences
0302 clinical medicine
Endocrinology
Diabetes mellitus
medicine
Glycemic
[SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism
lcsh:RC648-665
Endocrine and Autonomic Systems
business.industry
Medical record
Insulin
Type 2 Diabetes Mellitus
[SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism
medicine.disease
[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
3. Good health
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
Kidney disease
Research Article
Zdroj: International Journal of Endocrinology
International Journal of Endocrinology, Hindawi Publishing Corporation, 2013, 2013, pp.640632. ⟨10.1155/2013/640632⟩
International Journal of Endocrinology, Vol 2013 (2013)
ISSN: 1687-8345
1687-8337
DOI: 10.1155/2013/640632⟩
Popis: Aim. To understand glucose lowering therapeutic strategies of French general practitioners (GPs) in the management of type 2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD).Methods. A multicenter cross-sectional study was conducted from March to June 2011 among a sample of French GPs who contribute to the IMS Lifelink Disease Analyzer database. Eligible patients were those with T2DM and moderate-to-severe CKD who visited their GPs at least once during the study period. Data were collected through electronic medical records and an additional questionnaire.Results. 116 GPs included 297 patients: 86 with stage 3a (Group 1, GFR = 45–60 mL/min/1.73 m2) and 211 with stages 3b, 4, or 5 (Group 2, GFR < 45 mL/min/1.73 m2). Patients’ mean age was approximately 75 years. Insulin was used in 19% of patients, and was predominant in those with severe CKD. More than two-thirds of patients were treated with glucose lowering agents which were either contraindicated or not recommended for CKD. Conclusion Physicians most commonly considered the severity of diabetes and not CKD in their therapeutic decision making, exposing patients to potential iatrogenic risks. The recent patient oriented approach and individualization of glycemic objectives according to patient profile rather than standard HbA1c would improve this situation.
Databáze: OpenAIRE
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