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Treatment targets differ for patients with type 2 diabetes, hypertension
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Patient characteristics and overall comorbidity are used by treating physicians when deciding on individualized glucose and blood pressure targets, according to recent study findings published in BMC Endocrine Disorders.
Roland E. Schmieder, MD, of the Universitätsklinikum Erlangen in Germany, and colleagues evaluated 6,586 adults (median age, 65 years) with type 2 diabetes and hypertension from the DIALOGUE registry to determine individualized treatment targets and their effect on clinical practice.
Roland E. Schmieder
Poor glycemic control was identified with baseline fasting glucose of 8.5 mmol/L, postprandial glucose of 10.9 mmol/L and HbA1c of 7.8%. Mean BP was 140 mm Hg/83 mm Hg, and heart rates were found to be in the normal range. HbA1c treatment goals were divided into three categories: strict (≤ 6.5%), medium (> 6.5% to ≤ 7%) and loose (> 7% to ≤ 7.5%). Similar categories were evaluated for systolic BP: strict (≤ 130 mm Hg), medium (> 130 mm Hg to ≤ 135 mm Hg) and loose (> 135 mm Hg to ≤ 140 mm Hg).
Division of participants into the categories revealed similar characteristics between those in the two strict groups. Strict systolic BP and strict HbA1c goals were found among nearly 70% of participants; however, treatment goals for HbA1c were not met at the 6-month follow-up in any of the treatment groups.
The loose treatment group for systolic BP met treatment targets; however, the goals were not met by the strict and medium groups.
“Individualization of treatment in patients with diabetes and hypertension is well perceived but to reach HbA1c and BP targets is still challenging,” Schmieder told Endocrine Today. – by Amber Cox
Disclosure: Schmieder reports financial ties with Novartis. Please see the full study for a list of all other authors’ relevant financial disclosures.
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