Outcomes of adding second hypoglycemic drug after metformin monotherapy failure among type 2 diabetes in Hungary

G. Jermendy, Diana Erdesz, Laszlo Nagy, Don Yin, Hemant Phatak, Sudeep Karve, Samuel Engel, Rajesh Balkrishnan

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Aim: The objective of this observational study was to assess the status of glycemic control and associated patient-reported outcomes in ambulatory Hungarian patients with type 2 diabetes mellitus (T2DM) who were prescribed either a sulfonylurea (SU) or a thiazolidinedione (TZD) in addition to the prior metformin (MF) monotherapy. Methods: Type 2 diabetics aged ≥ 30 years and who had added an SU or TZD to previous MF monotherapy at least 1 year prior to the visit date were identified during January 2006 to March 2007. Information on HbA1c (A1C), medication use and co-morbid conditions was extracted from the medical record up to 6 months prior to the addition of SU or TZD to MF (baseline), and a minimum of one year after the initiation of either SU or TZD. Glycemic control (A1C <6.5%) was assessed using the last available A1C value in the medical record. Self-reported hypoglycemia, health-related quality of life (HRQoL) and treatment satisfaction were also assessed. Results: A total of 414 patients (82% SU+MF and 18% TZD+MF) with a mean age of 60.5 years (SD = 9.4 years) participated in the study. About 27% of patients reported hypoglycemic episodes, with about one-third reporting episodes that resulted into interruption of activities or required medical/non-medical assistance. Three quarters of patients were not at glycemic goal and BMI was the only factor significantly associated with failure to have an A1C level <6.5%. Patients' HRQoL was significantly associated with self-reported hypoglycemic episodes (p = 0.017), and duration of diabetes (p = 0.045). Conclusion: Nearly 75% of patients were not at A1C goal of <6.5% despite using two oral anti-hyperglycemic medications. Approximately 9% of patients reporting hypoglycemia required some kind of medical/ non-medical assistance. Greater BMI at baseline was associated with an A1C level ≥ 6.5%. Finally, self- reports of hypoglycemia and duration of diabetes were associated with low HRQoL.

Original languageEnglish
Article number88
JournalHealth and Quality of Life Outcomes
Volume6
DOIs
Publication statusPublished - Oct 31 2008

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Hungary
Metformin
Hypoglycemic Agents
Type 2 Diabetes Mellitus
Hypoglycemia
Quality of Life
Medical Records
Self Report
Observational Studies
2,4-thiazolidinedione

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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Outcomes of adding second hypoglycemic drug after metformin monotherapy failure among type 2 diabetes in Hungary. / Jermendy, G.; Erdesz, Diana; Nagy, Laszlo; Yin, Don; Phatak, Hemant; Karve, Sudeep; Engel, Samuel; Balkrishnan, Rajesh.

In: Health and Quality of Life Outcomes, Vol. 6, 88, 31.10.2008.

Research output: Contribution to journalArticle

Jermendy, G. ; Erdesz, Diana ; Nagy, Laszlo ; Yin, Don ; Phatak, Hemant ; Karve, Sudeep ; Engel, Samuel ; Balkrishnan, Rajesh. / Outcomes of adding second hypoglycemic drug after metformin monotherapy failure among type 2 diabetes in Hungary. In: Health and Quality of Life Outcomes. 2008 ; Vol. 6.
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abstract = "Aim: The objective of this observational study was to assess the status of glycemic control and associated patient-reported outcomes in ambulatory Hungarian patients with type 2 diabetes mellitus (T2DM) who were prescribed either a sulfonylurea (SU) or a thiazolidinedione (TZD) in addition to the prior metformin (MF) monotherapy. Methods: Type 2 diabetics aged ≥ 30 years and who had added an SU or TZD to previous MF monotherapy at least 1 year prior to the visit date were identified during January 2006 to March 2007. Information on HbA1c (A1C), medication use and co-morbid conditions was extracted from the medical record up to 6 months prior to the addition of SU or TZD to MF (baseline), and a minimum of one year after the initiation of either SU or TZD. Glycemic control (A1C <6.5{\%}) was assessed using the last available A1C value in the medical record. Self-reported hypoglycemia, health-related quality of life (HRQoL) and treatment satisfaction were also assessed. Results: A total of 414 patients (82{\%} SU+MF and 18{\%} TZD+MF) with a mean age of 60.5 years (SD = 9.4 years) participated in the study. About 27{\%} of patients reported hypoglycemic episodes, with about one-third reporting episodes that resulted into interruption of activities or required medical/non-medical assistance. Three quarters of patients were not at glycemic goal and BMI was the only factor significantly associated with failure to have an A1C level <6.5{\%}. Patients' HRQoL was significantly associated with self-reported hypoglycemic episodes (p = 0.017), and duration of diabetes (p = 0.045). Conclusion: Nearly 75{\%} of patients were not at A1C goal of <6.5{\%} despite using two oral anti-hyperglycemic medications. Approximately 9{\%} of patients reporting hypoglycemia required some kind of medical/ non-medical assistance. Greater BMI at baseline was associated with an A1C level ≥ 6.5{\%}. Finally, self- reports of hypoglycemia and duration of diabetes were associated with low HRQoL.",
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T1 - Outcomes of adding second hypoglycemic drug after metformin monotherapy failure among type 2 diabetes in Hungary

AU - Jermendy, G.

AU - Erdesz, Diana

AU - Nagy, Laszlo

AU - Yin, Don

AU - Phatak, Hemant

AU - Karve, Sudeep

AU - Engel, Samuel

AU - Balkrishnan, Rajesh

PY - 2008/10/31

Y1 - 2008/10/31

N2 - Aim: The objective of this observational study was to assess the status of glycemic control and associated patient-reported outcomes in ambulatory Hungarian patients with type 2 diabetes mellitus (T2DM) who were prescribed either a sulfonylurea (SU) or a thiazolidinedione (TZD) in addition to the prior metformin (MF) monotherapy. Methods: Type 2 diabetics aged ≥ 30 years and who had added an SU or TZD to previous MF monotherapy at least 1 year prior to the visit date were identified during January 2006 to March 2007. Information on HbA1c (A1C), medication use and co-morbid conditions was extracted from the medical record up to 6 months prior to the addition of SU or TZD to MF (baseline), and a minimum of one year after the initiation of either SU or TZD. Glycemic control (A1C <6.5%) was assessed using the last available A1C value in the medical record. Self-reported hypoglycemia, health-related quality of life (HRQoL) and treatment satisfaction were also assessed. Results: A total of 414 patients (82% SU+MF and 18% TZD+MF) with a mean age of 60.5 years (SD = 9.4 years) participated in the study. About 27% of patients reported hypoglycemic episodes, with about one-third reporting episodes that resulted into interruption of activities or required medical/non-medical assistance. Three quarters of patients were not at glycemic goal and BMI was the only factor significantly associated with failure to have an A1C level <6.5%. Patients' HRQoL was significantly associated with self-reported hypoglycemic episodes (p = 0.017), and duration of diabetes (p = 0.045). Conclusion: Nearly 75% of patients were not at A1C goal of <6.5% despite using two oral anti-hyperglycemic medications. Approximately 9% of patients reporting hypoglycemia required some kind of medical/ non-medical assistance. Greater BMI at baseline was associated with an A1C level ≥ 6.5%. Finally, self- reports of hypoglycemia and duration of diabetes were associated with low HRQoL.

AB - Aim: The objective of this observational study was to assess the status of glycemic control and associated patient-reported outcomes in ambulatory Hungarian patients with type 2 diabetes mellitus (T2DM) who were prescribed either a sulfonylurea (SU) or a thiazolidinedione (TZD) in addition to the prior metformin (MF) monotherapy. Methods: Type 2 diabetics aged ≥ 30 years and who had added an SU or TZD to previous MF monotherapy at least 1 year prior to the visit date were identified during January 2006 to March 2007. Information on HbA1c (A1C), medication use and co-morbid conditions was extracted from the medical record up to 6 months prior to the addition of SU or TZD to MF (baseline), and a minimum of one year after the initiation of either SU or TZD. Glycemic control (A1C <6.5%) was assessed using the last available A1C value in the medical record. Self-reported hypoglycemia, health-related quality of life (HRQoL) and treatment satisfaction were also assessed. Results: A total of 414 patients (82% SU+MF and 18% TZD+MF) with a mean age of 60.5 years (SD = 9.4 years) participated in the study. About 27% of patients reported hypoglycemic episodes, with about one-third reporting episodes that resulted into interruption of activities or required medical/non-medical assistance. Three quarters of patients were not at glycemic goal and BMI was the only factor significantly associated with failure to have an A1C level <6.5%. Patients' HRQoL was significantly associated with self-reported hypoglycemic episodes (p = 0.017), and duration of diabetes (p = 0.045). Conclusion: Nearly 75% of patients were not at A1C goal of <6.5% despite using two oral anti-hyperglycemic medications. Approximately 9% of patients reporting hypoglycemia required some kind of medical/ non-medical assistance. Greater BMI at baseline was associated with an A1C level ≥ 6.5%. Finally, self- reports of hypoglycemia and duration of diabetes were associated with low HRQoL.

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