Key result
In a review of 25,629 patients with type 2 diabetes, 44.5% achieved an HbA1c target of ≤7.0%, 35.2% achieved blood pressure ≤130/80 mmHg, and 51.4% achieved LDL-C ≤2.6 mmol/l.
A systematic review of over 25,000 patients with type 2 diabetes reveals that fewer than half achieve guideline-recommended targets for HbA1c, blood pressure, and LDL cholesterol, highlighting a significant gap in clinical care.
Gaps in risk factor control persist in type 2 diabetes; confirms need for improved implementation strategies in practice and research.
OBJECTIVE: To examine and compare the extent to which people with type 2 diabetes (T2DM) are achieving haemoglobin A1c (HbA1c), blood pressure (BP) and LDL cholesterol (LDL-C) treatment targets. METHODS: A review of databases (MEDLINE Ovid, Pubmed and Sabinet) was performed and limited to the following terms: type 2 diabetes mellitus AND guideline AND goal achievement for the years 2009 to 2014 (five years). RESULTS: A total of 14 studies (25 629 patients) were selected across 19 different countries. An HbA1c level of 7.0% (or less) was achieved by 44.5% of subjects (range 19.2-70.5%), while 35.2% (range 7.4-66.3%) achieved BP of 130/80 mmHg (or less), and 51.4% (range 20.0-82.9%) had an LDL-C level of either 2.5 or 2.6 mmol/l (100 mg/dl or less). CONCLUSION: Despite guideline recommendations that lowering of HbA1c, BP and lipids to target levels in T2DM will lead to a reduction in morbidity and mortality rates, we found that control of these risk factors remains suboptimal, even across different settings.
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Pinchevsky et al. (2015) conducted a review in Type 2 diabetes mellitus (n=25,629). Guideline-recommended risk factor targets was evaluated on Achievement of major risk-factor targets (HbA1c, blood pressure, and LDL-C). In a review of 25,629 patients with type 2 diabetes, 44.5% achieved an HbA1c target of ≤7.0%, 35.2% achieved blood pressure ≤130/80 mmHg, and 51.4% achieved LDL-C ≤2.6 mmol/l.
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