Pre-existing cardiovascular diseases and glycemic control in patients with type 2 diabetes mellitus in Europe: a matched cohort studyReport as inadecuate

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Cardiovascular Diabetology

, 9:15

First Online: 21 April 2010Received: 22 February 2010Accepted: 21 April 2010


BackgroundAlthough there is a growing body of evidence showing that patients with type 2 diabetes mellitus T2DM have poor glycemic control in general, it is not clear whether T2DM patients with pre-existing cardiovascular diseases CVD are more or less likely to have good glycemic control than patients without pre-existing CVD. Our aim was to examine the degree of glycemic control among T2DM patients in Europe with and without pre-existing CVD.

MethodsThis is a matched cohort study based on a multi-center, observational study with retrospective medical chart reviews of T2DM patients in Spain, France, United Kingdom, Norway, Finland, Germany, and Poland. Included patients were aged >= 30 years at time of diagnosis of T2DM, had added a SU or a PPARγ agonist to failing metformin monotherapy index date and had pre-existing CVD cases. A control cohort with T2DM without pre-existing CVD was identified using 1:1 propensity score matching. With difference-in-difference approach, logistic and linear regression analyses were applied to identify differences in glycemic control by CVD during the follow up period, after controlling for baseline demographics, clinical information, and concurrent anti-hyperglycemic medication use.

ResultsThe percentage of case patients with adequate glycemic control relative to control patients during the 1st, 2nd, 3rd, and 4th years after the index date was 19.9 vs. 26.5, 16.8 vs. 26.5, 18.8 vs. 28.3, and 16.8 vs. 23.5 respectively. Cases were significantly less likely to have adequate glycemic control odds ratio: 0.62; 95% confidence interval: 0.46-0.82 than controls after adjusting for baseline differences, secular trend, and other potential confounding covariates.

ConclusionsT2DM patients with pre-existing CVD tended to have poorer glycemic control than those without pre-existing CVD, all other factors being equal. It suggests that clinicians may need to pay more attention to glycemic control among T2DM patients with CVD.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-9-15 contains supplementary material, which is available to authorized users.

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Author: Alex Z Fu - Ying Qiu - Larry Radican - Donald D Yin - Panagiotis Mavros


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