Clinical Inertia and 2-Year Glycaemic Trajectories in Patients with Non-Newly Diagnosed Type 2 Diabetes Mellitus in Primary Care: A Retrospective Cohort Study

作者：Ling-Wang An, Xianglan Li, Linhui Chen, Hong Tang, Qun Yuan, Yanjun Liu, Yu Ji, Juming Lu · 发表于：Patient Preference and Adherence · 年份：2021 · DOI：10.2147/ppa.s328165 · 被引用次数：9 · 研究领域：Diabetes Management and Education、Diabetes Treatment and Management、Diabetes, Cardiovascular Risks, and Lipoproteins

Objective: To analyse diabetes treatment, treatment change and self-management behaviours in association with 2-year glycaemic trajectories in patients with non-newly diagnosed type 2 diabetes mellitus in Chinese primary care. Methods: This was an observational, multi-centre, longitudinal, retrospective cohort study. Clinical data of 4690 subjects were extracted from electronic medical records, including serial glycated haemoglobin A 1c (HbA 1c ) measurements, antidiabetic medication records and compliance to exercise, diet, medications and self-monitoring of blood glucose (SMBG). Patterns of longitudinal HbA1c trajectories were identified using the percentage of HbA 1c measurements < 7.5% from the second available HbA 1c measurement. Clinical relevance of the clusters was assessed through multivariable analysis. Results: Approximately half of the participants demonstrated good glycaemic control; of these, 34.5% demonstrated stable, good control, and 13.7% demonstrated relatively good control. About 16.2% demonstrated moderate control, and 35.6% demonstrated poor control. From the good to poor control groups, the percentage of subjects treated with insulin at baseline and during the follow-up period increased gradually, while the percentage of subjects adhering to exercise, diet, medications and SMBG decreased gradually. Compared with baseline, the adherence to exercise, diet, medications and SMBG improved significantly. Approximately 50% and 26% of subjects in the two poores...