Glycaemic control in the diabetes and lifestyle cohort twente: A cross-sectional assessment of lifestyle and pharmacological management on Hba1c target achievement

Annis C. Jalving, Christina M. Gant, S. Heleen Binnenmars, S.S. Soedamah-Muthu, Stephan J. L. Bakker, Gerjan Navis, Gozewijn D. Laverman

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Abstract

The majority of patients with type 2 diabetes do not reach target levels of glycated haemoglobin (HbA1c < 7%). We investigated the prevalence of HbA1c‐target achievement and opportunities afforded by lifestyle and pharmacological treatment to increase target achievement. We performed cross‐sectional analyses of baseline data from the Diabetes and Lifestyle Cohort Twente‐1 (DIALECT‐1). Patients were divided according to (1) HbA1c <53 and ≥53 mmol/mol (<7%) and (2) non‐insulin treatment and tertiles of daily insulin use. We found that 161 (36%) patients achieved the target HbA1c level. Patients with HbA1c ≥53 mmol/mol had a longer duration of diabetes (13 [8‐20] vs 9 [4‐14] years; P < .001) and more frequently were insulin‐users (76% vs 41%, P < .001). Patients in the highest tertile of insulin use had a higher body mass index than those in the lowest tertile (35.8 ± 5.5 vs 29.8 ± 5.5 kg/m2; P < .001). Achievement of target HbA1c is low in this type 2 diabetes population. High resistance to pharmacological treatment, paralleled with high body mass index, illustrates that increasing insulin sensitivity through lifestyle intervention is the best opportunity to improve HbA1c target achievement in this real‐life population.
Original languageEnglish
Pages (from-to)2494-2499
JournalDiabetes, Obesity and Metabolism
Volume20
Issue number10
DOIs
Publication statusPublished - 2018

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Type 2 Diabetes Mellitus
Body Mass Index
Glycosylated Hemoglobin A
Insulin Resistance

Keywords

  • METAANALYSIS
  • QUESTIONNAIRE
  • TYPE-2
  • VALIDITY
  • clinical diabetes
  • insulin therapy
  • nutrition and diet
  • oral pharmacological agents

Cite this

Jalving, Annis C. ; Gant, Christina M. ; Binnenmars, S. Heleen ; Soedamah-Muthu, S.S. ; Bakker, Stephan J. L. ; Navis, Gerjan ; Laverman, Gozewijn D. / Glycaemic control in the diabetes and lifestyle cohort twente : A cross-sectional assessment of lifestyle and pharmacological management on Hba1c target achievement. In: Diabetes, Obesity and Metabolism. 2018 ; Vol. 20, No. 10. pp. 2494-2499.
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abstract = "The majority of patients with type 2 diabetes do not reach target levels of glycated haemoglobin (HbA1c < 7{\%}). We investigated the prevalence of HbA1c‐target achievement and opportunities afforded by lifestyle and pharmacological treatment to increase target achievement. We performed cross‐sectional analyses of baseline data from the Diabetes and Lifestyle Cohort Twente‐1 (DIALECT‐1). Patients were divided according to (1) HbA1c <53 and ≥53 mmol/mol (<7{\%}) and (2) non‐insulin treatment and tertiles of daily insulin use. We found that 161 (36{\%}) patients achieved the target HbA1c level. Patients with HbA1c ≥53 mmol/mol had a longer duration of diabetes (13 [8‐20] vs 9 [4‐14] years; P < .001) and more frequently were insulin‐users (76{\%} vs 41{\%}, P < .001). Patients in the highest tertile of insulin use had a higher body mass index than those in the lowest tertile (35.8 ± 5.5 vs 29.8 ± 5.5 kg/m2; P < .001). Achievement of target HbA1c is low in this type 2 diabetes population. High resistance to pharmacological treatment, paralleled with high body mass index, illustrates that increasing insulin sensitivity through lifestyle intervention is the best opportunity to improve HbA1c target achievement in this real‐life population.",
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Glycaemic control in the diabetes and lifestyle cohort twente : A cross-sectional assessment of lifestyle and pharmacological management on Hba1c target achievement. / Jalving, Annis C.; Gant, Christina M.; Binnenmars, S. Heleen; Soedamah-Muthu, S.S.; Bakker, Stephan J. L.; Navis, Gerjan; Laverman, Gozewijn D.

In: Diabetes, Obesity and Metabolism, Vol. 20, No. 10, 2018, p. 2494-2499.

Research output: Contribution to journalArticleScientificpeer-review

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T1 - Glycaemic control in the diabetes and lifestyle cohort twente

T2 - A cross-sectional assessment of lifestyle and pharmacological management on Hba1c target achievement

AU - Jalving, Annis C.

AU - Gant, Christina M.

AU - Binnenmars, S. Heleen

AU - Soedamah-Muthu, S.S.

AU - Bakker, Stephan J. L.

AU - Navis, Gerjan

AU - Laverman, Gozewijn D.

PY - 2018

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N2 - The majority of patients with type 2 diabetes do not reach target levels of glycated haemoglobin (HbA1c < 7%). We investigated the prevalence of HbA1c‐target achievement and opportunities afforded by lifestyle and pharmacological treatment to increase target achievement. We performed cross‐sectional analyses of baseline data from the Diabetes and Lifestyle Cohort Twente‐1 (DIALECT‐1). Patients were divided according to (1) HbA1c <53 and ≥53 mmol/mol (<7%) and (2) non‐insulin treatment and tertiles of daily insulin use. We found that 161 (36%) patients achieved the target HbA1c level. Patients with HbA1c ≥53 mmol/mol had a longer duration of diabetes (13 [8‐20] vs 9 [4‐14] years; P < .001) and more frequently were insulin‐users (76% vs 41%, P < .001). Patients in the highest tertile of insulin use had a higher body mass index than those in the lowest tertile (35.8 ± 5.5 vs 29.8 ± 5.5 kg/m2; P < .001). Achievement of target HbA1c is low in this type 2 diabetes population. High resistance to pharmacological treatment, paralleled with high body mass index, illustrates that increasing insulin sensitivity through lifestyle intervention is the best opportunity to improve HbA1c target achievement in this real‐life population.

AB - The majority of patients with type 2 diabetes do not reach target levels of glycated haemoglobin (HbA1c < 7%). We investigated the prevalence of HbA1c‐target achievement and opportunities afforded by lifestyle and pharmacological treatment to increase target achievement. We performed cross‐sectional analyses of baseline data from the Diabetes and Lifestyle Cohort Twente‐1 (DIALECT‐1). Patients were divided according to (1) HbA1c <53 and ≥53 mmol/mol (<7%) and (2) non‐insulin treatment and tertiles of daily insulin use. We found that 161 (36%) patients achieved the target HbA1c level. Patients with HbA1c ≥53 mmol/mol had a longer duration of diabetes (13 [8‐20] vs 9 [4‐14] years; P < .001) and more frequently were insulin‐users (76% vs 41%, P < .001). Patients in the highest tertile of insulin use had a higher body mass index than those in the lowest tertile (35.8 ± 5.5 vs 29.8 ± 5.5 kg/m2; P < .001). Achievement of target HbA1c is low in this type 2 diabetes population. High resistance to pharmacological treatment, paralleled with high body mass index, illustrates that increasing insulin sensitivity through lifestyle intervention is the best opportunity to improve HbA1c target achievement in this real‐life population.

KW - METAANALYSIS

KW - QUESTIONNAIRE

KW - TYPE-2

KW - VALIDITY

KW - clinical diabetes

KW - insulin therapy

KW - nutrition and diet

KW - oral pharmacological agents

U2 - 10.1111/dom.13399

DO - 10.1111/dom.13399

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JO - Diabetes, Obesity and Metabolism

JF - Diabetes, Obesity and Metabolism

SN - 1462-8902

IS - 10

ER -