Keywords
glycated hemoglobin A
diabetes complications
metabolic control
hypoglycemic agents
How to Cite
Abstract
Background. Chronic hyperglycemia has been linked to the development of acute and chronic complications, so one of the primary interventions is to maintain appropriate glycemic control for each patient. Despite this, information on the matter continues to be limited.
Objective. To describe glycemic control in patients with diabetes mellitus and explore their behavior based on other clinical variables.
Methodology. Evaluation of a cohort of patients with diabetes from an endocrinology practice, assessed from January 2014 to December 2018. A descriptive analysis of sociodemographic and clinical variables was made. Data was collected from medical records, and characteristics were analyzed using frequencies and averages.
Results. Of the 661 patients, 27% of DM1 (type 1 diabetes mellitus) and 47.7% of DM2 (type 2 diabetes mellitus) had adequate glycemic control; when assessing the duration of the disease, the highest percentage of DM1 with adequate glycemic control (42%) had a recent diagnosis (less than five years) as in DM2 (41%). In terms of microvascular complications, the most frequent event was peripheral neuropathy in both groups of patients with diabetes with good glycemic control (8% of DM1 and 12% of DM2). Of the macrovascular complications there was only 1 case of PAD in DM1 in the group with inadequate glycemic control while in DM2 9.7% of patients with adequate glycemic control had a record of CAD (coronary artery disease). Finally, when considering hypoglycemic treatment, basal/bolus insulin therapy was the most used in DM1 in both glycemic control groups; and DM2 with good glycemic control, the most used therapies were metformin (6.4%) and metformin/IDPP4 in 8%.
Conclusions. Less than half of the study population had adequate glycemic control, being those with a recent diagnosis the largest group under this classification. There was a low frequency of microvascular and macrovascular complications, even in the group with inadequate glycemic control. Both groups of patients with diabetes with inadequate glycemic control recorded a higher frequency of hypoglycaemias, showing that an HbA1c measurement is insufficient to define glycemic control.
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