Lim, Lee-Ling and Hussein, Zanariah and Noor, Nurain Md and Abd Raof, Anis S. and Mustafa, Norlaila and Long Bidin, Mohamed B. and Ghani, Rohana Abdul and Samsuddin, Syahrizan and Yong, Sy-Liang and Foo, Siew-Hui and Raghuram, Kavitha and Suwannasri, Payiarat and Mohamad, Wan W.B. and Chiew, Thiam Kian and Chan, Siew Pheng (2024) Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study. PLoS ONE, 19 (1 Janu). ISSN 1932-6203, DOI https://doi.org/10.1371/journal.pone.0296298.
Full text not available from this repository.Abstract
Aim Given a lack of data on diabetes care performance in Malaysia, we conducted a cross-sectional study to understand the clinical characteristics, control of cardiometabolic risk factors, and patterns of use of guideline-directed medical therapy (GDMT) among patients with type 2 diabetes (T2D), who were managed at publicly-funded hospitals between December 2021 and June 2022. Methods Patients aged ≥18 years with T2D from eight publicly-funded hospitals in the Greater Kuala Lumpur region, who had ≥2 outpatient visits within the preceding year and irrespective of treatment regimen, were eligible. The primary outcome was ≥2 treatment target attainment (defined as either HbA1c <7.0, blood pressure BP <130/80 mmHg, or low-density lipoprotein cholesterol LDL-C <1.8 mmol/L). The secondary outcomes were the individual treatment target, a combination of all three treatment targets, and patterns of GDMT use. To assess for potential heterogeneity of study findings, all outcomes were stratified according to prespecified baseline characteristics namely 1) history of atherosclerotic cardiovascular disease (ASCVD; yes/no) and 2) clinic type (Diabetes specialist versus General medicine). Results Among 5094 patients (mean±SD age 59.0±13.2 years; T2D duration 14.8±9.2 years; HbA1c 8.2±1.9% (66±21 mmol/mol); BMI 29.6±6.2 kg/m2; 45.6% men), 99% were at high/very high cardiorenal risk. Attainment of ≥2 treatment targets was at 18%, being higher in General medicine than in Diabetes specialist clinics (20.8% versus 17.5%; p = 0.039). The overall statin coverage was 90%. More patients with prior ASCVD attained LDL-C <1.4 mmol/L than those without (13.5% versus 8.4%; p<0.001). Use of sodium-glucose cotransporter-2 (SGLT2) inhibitors (13.2% versus 43.2%), glucagon-like peptide-1 receptor agonists (GLP1-RAs) (1.0% versus 6.2%), and insulin (27.7% versus 58.1%) were lower in General medicine than in Diabetes specialist clinics. Conclusions Among high-risk patients with T2D, treatment target attainment and use of GDMT were suboptimal. © 2024 Lim et al.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Adolescent; Adult; Aged; Cholesterol, LDL; Cross-sectional studies; Diabetes mellitus, Type 2; Female; Glycated hemoglobin; Humans; Malaysia; Male; Middle aged; Treatment adherence and compliance; Alpha adrenergic receptor blocking agent; Antithrombocytic agent; Beta adrenergic receptor blocking agent; Calcium channel blocking agent; Cholesterol; Creatinine; Diuretic agent; Ezetimibe; Fenofibrate; Glucagon like peptide 1 receptor agonist; Hemoglobin A1c; High density lipoprotein cholesterol; Hydroxymethylglutaryl coenzyme A reductase inhibitor; Insulin; Low density lipoprotein cholesterol; Metformin; Sodium glucose cotransporter 2; Sodium glucose cotransporter 2 inhibitor; Sulfonylurea; Triacylglycerol; Glycated hemoglobin; Low density lipoprotein cholesterol; Adult |
| Subjects: | R Medicine |
| Divisions: | Faculty of Computer Science & Information Technology > Department of Software Engineering Faculty of Medicine > Medicine Department |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 03 May 2024 07:26 |
| Last Modified: | 03 May 2024 07:26 |
| URI: | http://eprints.um.edu.my/id/eprint/44935 |
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