Seasonal Variations in the Achievement of Guideline Targets for HbA1c, Blood Pressure, and Cholesterol Among Patients With Type 2 Diabetes: A Nationwide Population-Based Study (ABC Study: JDDM49)
Seasonal Variations in the Achievement of Guideline Targets for HbA1c, Blood Pressure, and Cholesterol Among Patients With Type 2 Diabetes: A Nationwide Population-Based Study (ABC Study: JDDM49)
复制标题
DOI：
10.2337/dc18-1953
复制
发表时间：
2019-05-01
期刊：
影响因子：
16.2
通讯作者：
Nishikawa, Masako
中科院分区：
文献类型：
--
作者：
Sakamoto, Masaya;Matsutani, Daisuke;Nishikawa, Masako
目的：达到HbA（1c）、血压（BP）和血脂水平指导目标的精确月成功率尚不清楚。我们每月评估2型糖尿病（T2DM）患者的成功率，并探讨相关因素。研究设计和方法本回顾性研究最初分析了全日本104,601例T2DM患者的数据。纳入在24个月内测量HbA（1c）、BP和LDL胆固醇（>= 12次）的患者。我们评估了每月的成就率。达到的目标定义为HbA(1c) = 25 kg/m(2) (BMI 25-30 kg/m(2), 0.45 [0.29-0.70]；BMI >= 30 kg/m(2), 0.35[0.22-0.57])和糖尿病病程>= 10年（0.53[0.37-0.76]）与低HbA（1c）成分率独立相关。在夏季和冬季，胰岛素和磺脲类药物的使用与所有ABC完成率的下降独立相关。结论：指南目标的所有ABC完成率逐月变化。在常规临床实践中管理T2DM时，应考虑所有ABC完成率的季节变化。
OBJECTIVE Precise monthly achievement rates for reaching guideline targets for HbA(1c), blood pressure (BP), and lipid levels remain unknown. We evaluated achievement rates on a monthly basis in persons with type 2 diabetes mellitus (T2DM) and explored related factors. RESEARCH DESIGN AND METHODS This retrospective study initially analyzed data on 104,601 persons with T2DM throughout Japan. Patients whose HbA(1c), BP, and LDL cholesterol were measured >= 12 times during a 24-month period were included. We evaluated monthly achievement rates. Achieved targets were defined as HbA(1c) = 25 kg/m(2) (BMI 25-30 kg/m(2), 0.45 [0.29-0.70]; BMI >= 30 kg/m(2), 0.35 [0.22-0.57]), and diabetes duration >= 10 years (0.53 [0.37-0.76]) were independently related to lower achievement rates for HbA(1c). Insulin use and sulfonylurea use were independently associated with the decreased all ABC achievement rates in both summer and winter. CONCLUSIONS The all ABC achievement rate for guideline targets changed on a monthly basis. Seasonal variations in the all ABC achievement rate should be considered when managing T2DM in ordinary clinical practices.