94-LB: Pharmacological Intensification in Patients with Type 2 Diabetes in a Low-Cost Diabetes Care Center (CAD)

Pharmacological intensification is one of the most important factors needed to get more patients to reach goals in type 2 diabetes mellitus (DM2). The objective of this research protocol is to demonstrate the degree of metabolic control in patients with DM2 and their glycemic control at 3, 6 months and 1 year after their pharmacological intensification in a Low Cost Diabetes Care Center (CAD). Descriptive, cross-sectional and retrospective study from 2019 to 2022, an HbA1c ≤ 7% was considered a meta control. Of the 422 patients studied, 66.8% (n=282/422) were women and 33.2% men. 33.2% comprised the 3-month cohort, 20.4% at 6 months, and 46.4% at 1 year. At the start of treatment in CAD, 81% of the patients were outside the goals, of these, 31.5% had an A1C between 7.1-9%, 49.4% between 9.1-12% and 19% ≥12.1%. Regarding treatment, 12.6% had no drug treatment, 34.6% monotherapy, 45.7% double oral therapy, 6.6% triple and 0.5% quadruple. 20.1% of the participants used insulin and 0.9% GLP-1. 78.9% were taking metformin, 36.7% sulfonylureas, 15.4% IDPP4, 6.2% ISGLT2, 5.9% acarbose, and 4.7% TZDs. During pharmacological intensification there was an increase in the use of medications: Metformin +18.3%, IDPP4 +26.1%, iSGLT2 +25.8% and TZD +12.4%. Glibenclamide was reduced to -6%, all of them statistically significant (p=0.000). Patients without treatment decreased from 12.6 to 1.4% (p= 0.005) and in monotherapy from 34.6 to 15.9% (p= 0.000), dual therapy increased from 45.7 to 50.9%, triple from 6.6 to 27% and quadruple from 0.5 to 4.7% (p=0.003). The use of insulin doubled from 20.81 to 44.3%, likewise GLP-1 from 0.9 to 6.4%; both were statistically significant (p=.000). According to glycemic control, at 3 months 89.3% improved their glucose levels and 35% of the participants reached control goals, at 6 months 94.2% improved their glucose levels and 53. 5% achieved their control goals. At one year, 90.3% improved their glucose levels and 71.4% reached control goals.