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Treating to goal: challenges of current management
1University of Birmingham and Birmingham Heartlands Hospital, Department of Medicine Undergraduate Centre, Bordesley Green East, Birmingham, B9 5SS, UK. anthony.barnett@heartsol.wmids.nhs.uk
European Journal of Endocrinology
|October 19, 2004
Summary
Achieving glycated haemoglobin (HbA1c) goals improves health and economic outcomes for type 2 diabetes patients. Overcoming barriers to blood glucose control is crucial for managing vascular complications and improving patient self-management.
Area of Science:
- Diabetes Mellitus Research
- Endocrinology
- Public Health
Background:
- Extensive evidence supports treating to glycated haemoglobin (HbA1c) goals for health and economic benefits in type 2 diabetes.
- Vascular complication risk in type 2 diabetes is strongly correlated with HbA1c levels and duration of poor glycemic control.
- Despite proven benefits, most patients exceed target HbA1c levels, indicating a universal problem of poor glycemic control.
Purpose of the Study:
- To highlight the benefits of achieving glycemic control in type 2 diabetes.
- To identify barriers hindering optimal blood glucose management.
- To emphasize the need to overcome these barriers for improved patient outcomes.
Main Methods:
- Review of extensive evidence from clinical trials like UKPDS and DCCT.
- Analysis of factors contributing to poor glycemic control.
- Identification of therapy-, patient-, and healthcare system-related barriers.
Main Results:
- Good glycemic control significantly reduces the risk of vascular complications.
- Numerous pharmacological agents can reduce HbA1c levels.
- Barriers to good blood glucose control are multifaceted and prevalent.
Conclusions:
- Poor glycemic control is a growing global issue in type 2 diabetes.
- Barriers include declining beta-cell function, therapy issues (efficacy, hypoglycemia fear, compliance), patient factors (lifestyle, education, psychology), and healthcare system access.
- Overcoming these barriers is essential to realize the benefits of near-normal glucose levels for more patients.