Previous studies have shown suboptimal glycemic control among patients with type 2 diabetes (T2D); however, the level of glycemic control has not been specifically evaluated for different degrees of treatment intensity. To assess this, we used the Quintiles Electronic Medical Record database to examine T2D patients ≥18 years with ≥1 encounter from Oct 2014 to Sept 2015, ≥1 year of available medical history, ≥1 HbA1c measure, and no insulin use at their last recorded encounter. Of the 678,447 eligible patients, median age was 65 years, 54% were female, and median HbA1c was 6.5%. The table shows the distribution of HbA1c range vs. treatment intensity. Overall, 32% of patients had suboptimal HbA1c levels (≥7%). Of those patients, 10% were untreated, 35% were on monotherapy, and 55% were not at goal despite being on 2 or 3+ agents. In patients with HbA1c ≥9%, 9% were untreated and 28% were on monotherapy. Among patients at the treatment target of <7%, only 24% were on dual or triple therapy, suggesting that patients on monotherapy who are not at goal were not consistently advanced to dual/triple therapy. Results were generally similar when subgroups with/without cardiovascular disease were examined.
In conclusion, 32% of our cohort had suboptimal HbA1c control. Given the distribution of therapy, opportunity exists to initiate/intensify treatment to improve glycemic control in this population.
K. Iglay: Employee; Self; Merck & Co., Inc.. Stock/Shareholder; Self; Merck & Co., Inc. H. Hannachi: Employee; Self; Merck & Co., Inc. S.S. Engel: Employee; Self; Merck & Co., Inc.. Stock/Shareholder; Self; Merck & Co., Inc.. X. Li: None. D.J. O'Connell: None. L.M. Moore: None. S. Rajpathak: Employee; Self; Merck & Co., Inc..