Depression and microvascular complications predict poor goal achievement among Colombian patients with type 2 diabetes
PDF (Español (España))
HTML (Español (España))

Keywords

Diabetes
metabolic control
HbA1c
chronic disease
chronic complications

How to Cite

Sanmiguel, C., Luna, M. C., Kattah, W., & Mendivil, C. O. (2017). Depression and microvascular complications predict poor goal achievement among Colombian patients with type 2 diabetes. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 3(2), 36–47. https://doi.org/10.53853/encr.3.2.31

Abstract

Aims: Many patients with type 2 diabetes (DM2) in Latin American countries remain insufficiently controlled. We aimed to identify factors associated with persistent poor metabolic control in Colombian patients with DM2.
Methods: Retrospective one-year follow-up cohort study of adult patients with DM2. The primary outcome was persistent poor metabolic control (PPMC): HbA1c level >8% in all measurements during follow-up. Secondary outcomes were intermittent poor metabolic control (IPMC) and good control (GC: simultaneous achievement of HbA1c, blood pressure and LDL cholesterol goals). Multiple demographic, clinical and laboratory variables were predictors in multivariable logistical models. Results: Of 399 patients included, 50 had the primary endpoint during follow-up. Older age was negatively associated with PPMC (OR 0.40, 95%CI 0.17-0.92 for extreme quartiles), even after multivariate adjustment. Depression and the presence of multiple microvascular complications were strongly associated with the secondary endpoint IPMC (multivariate OR respectively 4.2, 95%CI 1.08-16.4 for depression; 5.61, 95%CI 1.03-30.6 for microvascular complications). Being unemployed was associated with significantly less odds of achieving GC (multivariate OR 0.19, 95%CI 0.04-0.95). Conclusions: Age, depression, the presence of microvascular complications and employment status were associated with the success or failure of diabetes management. These factors were better correlates of therapeutic success than the pharmacological agent employed.

https://doi.org/10.53853/encr.3.2.31
PDF (Español (España))
HTML (Español (España))

References

1. International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium: International Diabetes Federation, 2013. http://www.idf.org/dia- betesatlas. Accessed last time on July 7, 2015.
2. Pan American Health Organization. Healthy Aging and Non-Communicable Diseases. Available at: http://new.paho.org/hq/index.php?option=com_ docman&task=doc_view&gid=17324&Itemid. Accessed last time on July 7, 2015.
3. Aschner P. Epidemiología de la diabetes en Colombia. Av Diabetol 2010;26:95-100.
4. Colombian National Administrative Department of Statistics (DANE): Basic health indicators 2010. Available at: www.dane.gov.co/daneweb_V09. Accessed last time on July 7, 2015.
5. The Diabetes Control and Complications Trial Group. The effect of intensive treatment of diabetes on the development and progression of long—term complications in insulin-dependent diabetes mellitus. New Engl J Med 1993;329:977-986.
6. Epidemiology of Diabetes Intervention and Complications Research Group. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. New Engl J Med 2009;342:381-390.
7. UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood- glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998;352:854–865.
8. Shichiri M1, Kishikawa H, Ohkubo Y, Wake N. Long-term results of the Kumamoto Study on optimal diabetes control in type 2 diabetic patients. Diabetes Care 2000;23 (Suppl 2):B21-9.
9. Gaede P, Vedel P, Larsen N, Jensen G, Parving HP, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 2003;345:383-393.
10. American Diabetes Association. Executive summary: standards of medical care in diabetes-2014. Diabetes Care 2014;37 (Suppl 1):S5-13.
11. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M et al. Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2012;55:1577-96.
12. Latin American Diabetes Association – ALAD. Guías ALAD sobre el diagnóstico, control y tratamiento de la diabetes mellitus tipo 2 con medicina basada en evidencia, edición 2013. Rev Asoc Latinoam Diabetes 2014:2013 (Suppl 1):1-142.
13. Mohammed K, Kai MB, Saaddine JB, Cowie C, Imperatore G, Gregg EW. Achievement of Goals in U.S. Diabetes Care, 1999–2010. N Engl J Med
2013;368:1613–24.
14. Harris SB, Ekoé JM, Zdanowicz Y, Webster-Bogaert S. Glycemic control and morbidity in the Canadian primary care setting (results of the Diabetes in Canada Evaluation Study). Diabetes Res Clin Pract 2005;70:90-7.
15. Liebl A1, Mata M, Eschwège E; ODE-2 Advisory Board. Evaluation of risk factors for development of complications in Type II diabetes in Europe. Diabetologia 2002;45:S23-8.
16. Villegas A, Abad SB, Faciolince S, Hernández N, Maya C, Parra L et al. Controlling diabetes mellitus and its complications in Medellín, Colombia,
2001-2003. 2001-2003. Pan Am J Public Health 2006;20:397-402.
17. Figueroa CL, Gamarra G. Factors associated with no metabolic control in diabetics belonging to a program of cardiovascular risk. Acta Med Colomb 2013;38: 213-221.
18. Kattah W, Coral P, Mendez F. Assessment of the impact of a treatment and education program in reducing glycated hemoglobin levels in diabetic patients. Acta Med Colomb 2007;32: 206-211.
19. Ramal E, Petersen AB, Ingram KM, Champlin AM. Factors that influence diabetes self-management in Hispanics living in low socioeconomic neighborhoods in San Bernardino, California. J Immigr Minor Health 2012;14:1090-6.
20. Chew BH, Ghazali SS, Ismail M, Haniff J, Bujang MA. Age ? 60 years was an independent risk factor for diabetes-related complications despite good control of cardiovascular risk factors in patients with type 2 diabetes mellitus. Exp Gerontol 2013;48:485-91.
21. Rush WA, Whitebird RR, Rush MR, Solberg LI, O’Connor PJ. Depression in patients with diabetes: does it impact clinical goals? J Am Board Fam Med 2008;21:392-7.
22. Grey M1, Davidson M, Boland EA, Tamborlane WV. Clinical and psychosocial factors associated with achievement of treatment goals in adolescents with diabetes mellitus. J Adolesc Health 2001;28:377-85.
23. De la Roca-Chiapas JM, Hernández-González M, Candelario M, Villafaña M de L, Hernández E, Solorio S et al. Association between depression and higher glucose levels in middle-aged Mexican patients with diabetes. Rev Invest Clin 2013;65:209-13.
24. Sumlin LL, Garcia TJ, Brown SA, Winter MA, García AA, Brown A, Cuevas HE. Depression and adherence to lifestyle changes in type 2 diabetes: a systematic review. Diabetes Educ 2014;40:731-44.
25. Chew BH, Hassan NH2, Sherina MS. Determinants of medication adherence among adults with type 2 diabetes mellitus in three Malaysian public health clinics: a cross-sectional study. Patient Prefer Adherence 2015;9:639-48.
26. Wagner JA, Tennen H, Osborn CY. Lifetime depression and diabetes self- management in women with Type 2 diabetes: a case-control study. Diabet Med 2010;27:713-7.
27. Wu B1, Jin H, Vidyanti I, Lee PJ, Ell K, Wu S. Collaborative depression care among Latino patients in diabetes disease management, Los Angeles, 2011- 2013. Prev Chronic Dis 2014;11:E148.
28. Navarro-Vidal B, Banegas JR, León-Muñoz LM, Rodríguez-Artalejo F, Graciani A. Achievement of cardiometabolic goals among diabetic patients in Spain. A nationwide population-based study. PLoS One 2013;8:e61549.
29. Stark Casagrande S, Fradkin JE, Saydah SH, Rust KF, Cowie CC. The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes, 1988-2010. Diabetes Care 2013;36:2271-9.
30. DeGuzman PB, Akosah KO, Simpson AG, Barbieri KE, Megginson GC, Gold- berg RI et al. Sub-optimal achievement of guideline-derived lipid goals in management of diabetes patients with atherosclerotic cardiovascular disease, despite high use of evidence-based therapies. Diab Vasc Dis Res 2012;9:138-45.
31. Shi L1, Ye X, Lu M, Wu EQ, Sharma H, Thomason D et al. Clinical and economic benefits associated with the achievement of both HbA1c and LDL cholesterol goals in veterans with type 2 diabetes. Diabetes Care 2013;36:3297-304.

Authors must state that they reviewed, validated and approved the manuscript's publication.  Moreover, they must sign a model release that should be sent.  A copy may be reviewed here

Dimensions


PlumX


Downloads

Download data is not yet available.