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[Compliance and optimisation of oral antidiabetic therapy. A longitudinal study]
1Service de médecine B, hôpital Lariboisière, 2 rue Ambroise Paré, 75010 Paris Université Paris 7. jean-guillausseau@lrb.ap-hop-paris.fr
Objective:
To evaluate the impact of optimization of treatment and improvement in observance awareness in patients with type 2 diabetes on compliance with oral antidiabetic drug therapy and long-term glycemic control. Method Evaluation of compliance with oral antidiabetic therapy and of HbA1c levels in a cohort of 4 802 patients with type 2 diabetes followed by their general practitioner, before and after 6 Months on optimized treatment: reduction in percentage of combination treatments from 69.5 to 56.8%, and increase in percentage of once-daily dosing regimen from 12 to 58.4%.
Results:
Optimization of treatment led to an increase in the percentage of patients achieving optimal compliance with oral antidiabetic drug therapy from 44 to 69.5% after 6 Months (p<0.001). Metabolic control also improved, as evidenced by a decrease in HbA1c levels observed both in the whole cohort (7.5+/-1.6% to 6.9+/-1.2%; p<0.0005), as well as in individual therapeutic subgroups of patients (having switched from multiple-daily dosing to once-daily-dosing schedules and from gliclazide 80 to gliclazide 30 MR once-daily formulation).
Conclusion:
These findings suggest that optimization of oral antidiabetic therapy favoring the use of oral antidiabetic agents with once-daily dosing administration modalities may improve metabolic control in patients with type 2 diabetes.
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