Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment

Autores
Gagliardino, Juan Jose; Elgart, Jorge Federico; Forti, Luján; Guaita, María Silvina; Chantelot, Jean M.
Año de publicación
2019
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: To evaluate the relation between different serum lipid fractions and other known barriers to attain the HbA1c ≤ 7.0% (53 mmol/mol) target. Methods: Data on 2719 patients with type 2 diabetes were collected from the five waves of the International Diabetes Mellitus Practice Study implemented in Argentina (2006 to 2012) including demographic/socioeconomic profile, clinical, metabolic (HbA1c and serum lipids) data, and treatment type and also, percentage of treatment goal attainment. Descriptive statistical analyses included ANOVA, χ2 test, and Fisher exact test and univariate and multivariate logistic regression analyses, which identified predictive factors for HbA1c ≤ 7% (53 mmol/mol). Results: The average age was 63 years, primary/secondary education, health insurance, 10‐year type 2 diabetes duration, most associated with cardiovascular risk factors and some microvascular/macrovascular complications; 94.5% received antihyperglycaemic drugs. Percentage of people on target: HbA1c 51.2%, blood pressure 23.5%, total cholesterol 62.6%, low‐density lipoprotein (LDL) cholesterol 38.9%, and triglycerides 61.1%. HbA1c on target depended markedly on treatment type: more of those treated with lifestyle changes and significantly fewer of those receiving insulin. Only 4.1% had all parameters simultaneously on target. Multivariate logistic regression analyses showed that achieving HbA1c ≤ 7.0% (53 mmol/mol) was associated with higher educational level, shorter diabetes duration, and having reached goals for LDL cholesterol and triglycerides, whereas opposite results were obtained with insulin treatment and longer diabetes duration. Conclusions: High LDL cholesterol and triglyceride levels simultaneously potentiate development/progression of chronic complications, exerting this effect in the long term by decreasing β‐cell mass/function, thereby making it more difficult to reach HbA1c values able to prevent complications.
Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; Argentina
Fil: Elgart, Jorge Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; Argentina
Fil: Forti, Luján. Sanofi Aventis Argentina Sociedad Anonima.; Argentina
Fil: Guaita, María Silvina. Sanofi Aventis Argentina Sociedad Anonima.; Argentina
Fil: Chantelot, Jean M.. Sanofi; Francia
Materia
HAEMOGLOBIN A1C
LDL CHOLESTEROL
LIPID PROFILES
Β CELL
Β-CELL-A1C TARGET
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/122250
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/122250
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainmentGagliardino, Juan JoseElgart, Jorge FedericoForti, LujánGuaita, María SilvinaChantelot, Jean M.HAEMOGLOBIN A1CLDL CHOLESTEROLLIPID PROFILESΒ CELLΒ-CELL-A1C TARGEThttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background: To evaluate the relation between different serum lipid fractions and other known barriers to attain the HbA1c ≤ 7.0% (53 mmol/mol) target. Methods: Data on 2719 patients with type 2 diabetes were collected from the five waves of the International Diabetes Mellitus Practice Study implemented in Argentina (2006 to 2012) including demographic/socioeconomic profile, clinical, metabolic (HbA1c and serum lipids) data, and treatment type and also, percentage of treatment goal attainment. Descriptive statistical analyses included ANOVA, χ2 test, and Fisher exact test and univariate and multivariate logistic regression analyses, which identified predictive factors for HbA1c ≤ 7% (53 mmol/mol). Results: The average age was 63 years, primary/secondary education, health insurance, 10‐year type 2 diabetes duration, most associated with cardiovascular risk factors and some microvascular/macrovascular complications; 94.5% received antihyperglycaemic drugs. Percentage of people on target: HbA1c 51.2%, blood pressure 23.5%, total cholesterol 62.6%, low‐density lipoprotein (LDL) cholesterol 38.9%, and triglycerides 61.1%. HbA1c on target depended markedly on treatment type: more of those treated with lifestyle changes and significantly fewer of those receiving insulin. Only 4.1% had all parameters simultaneously on target. Multivariate logistic regression analyses showed that achieving HbA1c ≤ 7.0% (53 mmol/mol) was associated with higher educational level, shorter diabetes duration, and having reached goals for LDL cholesterol and triglycerides, whereas opposite results were obtained with insulin treatment and longer diabetes duration. Conclusions: High LDL cholesterol and triglyceride levels simultaneously potentiate development/progression of chronic complications, exerting this effect in the long term by decreasing β‐cell mass/function, thereby making it more difficult to reach HbA1c values able to prevent complications.Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; ArgentinaFil: Elgart, Jorge Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; ArgentinaFil: Forti, Luján. Sanofi Aventis Argentina Sociedad Anonima.; ArgentinaFil: Guaita, María Silvina. Sanofi Aventis Argentina Sociedad Anonima.; ArgentinaFil: Chantelot, Jean M.. Sanofi; FranciaJohn Wiley & Sons Ltd2019-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/122250Gagliardino, Juan Jose; Elgart, Jorge Federico; Forti, Luján; Guaita, María Silvina; Chantelot, Jean M.; Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment; John Wiley & Sons Ltd; Diabetes/metabolism Research and Reviews; 35; 6; 5-2019; 1-71520-7552CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1002/dmrr.3166info:eu-repo/semantics/altIdentifier/doi/10.1002/dmrr.3166info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T10:03:40Zoai:ri.conicet.gov.ar:11336/122250instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 10:03:41.185CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment
title Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment
spellingShingle Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment
Gagliardino, Juan Jose
HAEMOGLOBIN A1C
LDL CHOLESTEROL
LIPID PROFILES
Β CELL
Β-CELL-A1C TARGET
title_short Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment
title_full Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment
title_fullStr Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment
title_full_unstemmed Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment
title_sort Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment
dc.creator.none.fl_str_mv Gagliardino, Juan Jose
Elgart, Jorge Federico
Forti, Luján
Guaita, María Silvina
Chantelot, Jean M.
author Gagliardino, Juan Jose
author_facet Gagliardino, Juan Jose
Elgart, Jorge Federico
Forti, Luján
Guaita, María Silvina
Chantelot, Jean M.
author_role author
author2 Elgart, Jorge Federico
Forti, Luján
Guaita, María Silvina
Chantelot, Jean M.
author2_role author
author
author
author
dc.subject.none.fl_str_mv HAEMOGLOBIN A1C
LDL CHOLESTEROL
LIPID PROFILES
Β CELL
Β-CELL-A1C TARGET
topic HAEMOGLOBIN A1C
LDL CHOLESTEROL
LIPID PROFILES
Β CELL
Β-CELL-A1C TARGET
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: To evaluate the relation between different serum lipid fractions and other known barriers to attain the HbA1c ≤ 7.0% (53 mmol/mol) target. Methods: Data on 2719 patients with type 2 diabetes were collected from the five waves of the International Diabetes Mellitus Practice Study implemented in Argentina (2006 to 2012) including demographic/socioeconomic profile, clinical, metabolic (HbA1c and serum lipids) data, and treatment type and also, percentage of treatment goal attainment. Descriptive statistical analyses included ANOVA, χ2 test, and Fisher exact test and univariate and multivariate logistic regression analyses, which identified predictive factors for HbA1c ≤ 7% (53 mmol/mol). Results: The average age was 63 years, primary/secondary education, health insurance, 10‐year type 2 diabetes duration, most associated with cardiovascular risk factors and some microvascular/macrovascular complications; 94.5% received antihyperglycaemic drugs. Percentage of people on target: HbA1c 51.2%, blood pressure 23.5%, total cholesterol 62.6%, low‐density lipoprotein (LDL) cholesterol 38.9%, and triglycerides 61.1%. HbA1c on target depended markedly on treatment type: more of those treated with lifestyle changes and significantly fewer of those receiving insulin. Only 4.1% had all parameters simultaneously on target. Multivariate logistic regression analyses showed that achieving HbA1c ≤ 7.0% (53 mmol/mol) was associated with higher educational level, shorter diabetes duration, and having reached goals for LDL cholesterol and triglycerides, whereas opposite results were obtained with insulin treatment and longer diabetes duration. Conclusions: High LDL cholesterol and triglyceride levels simultaneously potentiate development/progression of chronic complications, exerting this effect in the long term by decreasing β‐cell mass/function, thereby making it more difficult to reach HbA1c values able to prevent complications.
Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; Argentina
Fil: Elgart, Jorge Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; Argentina
Fil: Forti, Luján. Sanofi Aventis Argentina Sociedad Anonima.; Argentina
Fil: Guaita, María Silvina. Sanofi Aventis Argentina Sociedad Anonima.; Argentina
Fil: Chantelot, Jean M.. Sanofi; Francia
description Background: To evaluate the relation between different serum lipid fractions and other known barriers to attain the HbA1c ≤ 7.0% (53 mmol/mol) target. Methods: Data on 2719 patients with type 2 diabetes were collected from the five waves of the International Diabetes Mellitus Practice Study implemented in Argentina (2006 to 2012) including demographic/socioeconomic profile, clinical, metabolic (HbA1c and serum lipids) data, and treatment type and also, percentage of treatment goal attainment. Descriptive statistical analyses included ANOVA, χ2 test, and Fisher exact test and univariate and multivariate logistic regression analyses, which identified predictive factors for HbA1c ≤ 7% (53 mmol/mol). Results: The average age was 63 years, primary/secondary education, health insurance, 10‐year type 2 diabetes duration, most associated with cardiovascular risk factors and some microvascular/macrovascular complications; 94.5% received antihyperglycaemic drugs. Percentage of people on target: HbA1c 51.2%, blood pressure 23.5%, total cholesterol 62.6%, low‐density lipoprotein (LDL) cholesterol 38.9%, and triglycerides 61.1%. HbA1c on target depended markedly on treatment type: more of those treated with lifestyle changes and significantly fewer of those receiving insulin. Only 4.1% had all parameters simultaneously on target. Multivariate logistic regression analyses showed that achieving HbA1c ≤ 7.0% (53 mmol/mol) was associated with higher educational level, shorter diabetes duration, and having reached goals for LDL cholesterol and triglycerides, whereas opposite results were obtained with insulin treatment and longer diabetes duration. Conclusions: High LDL cholesterol and triglyceride levels simultaneously potentiate development/progression of chronic complications, exerting this effect in the long term by decreasing β‐cell mass/function, thereby making it more difficult to reach HbA1c values able to prevent complications.
publishDate 2019
dc.date.none.fl_str_mv 2019-05
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/122250
Gagliardino, Juan Jose; Elgart, Jorge Federico; Forti, Luján; Guaita, María Silvina; Chantelot, Jean M.; Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment; John Wiley & Sons Ltd; Diabetes/metabolism Research and Reviews; 35; 6; 5-2019; 1-7
1520-7552
CONICET Digital
CONICET
url http://hdl.handle.net/11336/122250
identifier_str_mv Gagliardino, Juan Jose; Elgart, Jorge Federico; Forti, Luján; Guaita, María Silvina; Chantelot, Jean M.; Treat-to-target HbA1c and lipid profile to prolong β-cell mass/function and optimize treatment goal attainment; John Wiley & Sons Ltd; Diabetes/metabolism Research and Reviews; 35; 6; 5-2019; 1-7
1520-7552
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1002/dmrr.3166
info:eu-repo/semantics/altIdentifier/doi/10.1002/dmrr.3166
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv John Wiley & Sons Ltd
publisher.none.fl_str_mv John Wiley & Sons Ltd
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1842269813650489344
score 13.13397

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