Characteristics and treatment patterns of patients with type 2 diabetes in lebanon: The discover study
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World Health Organization
Abstract
Background: Lebanon is part of the global DISCOVER study, a global, noninterventional, multicentre, prospective study with 3-years of follow-up. Aims: The aim of this study is to describe real-world clinical practice in terms of type 2 diabetes mellitus (T2DM) disease management and treatment patterns within Lebanon. Methods: Baseline demographic and clinical parameters were captured on a standardized case report form, according to routine clinical practice at each clinical site. Results: We recruited 348 patients. At the initiation of second-line therapy, mean duration of diabetes was 6.7 [standard deviation (SD) 6.5] years; mean HbA1c and fasting plasma glucose levels were 8.5% (SD 1.6%) and 178.7 (SD 56.5) mg/dL re-spectively. Almost half the patients were hypertensive (45.1%) or had dyslipidaemia (48.6%). Metformin monotherapy was used as first-line therapy in 56.9% of the patients and upfront dual therapy in 25%. The primary reason for changing first-line therapy was poor glycaemic control. The main factors in choosing the second-line therapy were efficacy, tolerability and hypoglycaemia. Conclusion: Clinical inertia was evident in this cohort of patients as they had suboptimal glycaemic control at the time of enrolment and the initiation of second-line therapy. Treatment intensification is required to reduce diabetes-related adverse outcomes. © World Health Organization (WHO) 2021.
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2nd-line treatment, Discover study, Lebanon, Oral glucose-lowering agents, Type 2 diabetes, Blood glucose, Diabetes mellitus, type 2, Glycated hemoglobin a, Humans, Hypoglycemic agents, Metformin, Prospective studies, Treatment outcome, 2,4 thiazolidinedione derivative, Acetylsalicylic acid, Angiotensin receptor antagonist, Antilipemic agent, Beta adrenergic receptor blocking agent, Calcium channel blocking agent, Clopidogrel, Dipeptidyl carboxypeptidase inhibitor, Dipeptidyl peptidase iv inhibitor, Hemoglobin a1c, Insulin, Sulfonylurea, Antidiabetic agent, Glycosylated hemoglobin, Adult, Alcohol consumption, Antidiabetic activity, Article, Drug efficacy, Drug tolerability, Dyslipidemia, Female, Glucose blood level, Glycemic control, Human, Hypertension, Hypoglycemia, Major clinical study, Male, Middle aged, Monotherapy, Multivariate analysis, Non insulin dependent diabetes mellitus, Proportional hazards model, Smoking, Statistical analysis, Prospective study