Evaluation of the rate of achieving the treatment goals and the change in the medication therapy of patients with type2 diabetes

Background: The incidence of Type-2 DM continues to increase whereas new agents are involved in treatment options. No sufficient data are available on the rate changes regarding diabetic achievements in the Turkish population over the years. Objectives: In the study, we aimed to evaluate the 2008 and 2018 data of type-2 diabetes mellitus (T2DM) patients followed in the diabetes outpatient clinic of our hospital in terms of diabetic achievements and treatment preference. Methods: Files of T2DM patients followed in our hospital's diabetes outpatient clinic in 2008 and 2018 and hospital information processing data were evaluated retrospectively. Glycemic values, BMI, renal functions, lipid profiles, and drug use characteristics of the patients for both periods were compared. Results: A total of 449 patients, 185 male and 264 female, in 2008 and a total of 450 patients, 172 male and 278 female, in 2018 were included in the study. The mean body mass index (BMI) in 2018 was found to be higher than in 2008 (30.84±5.19 vs. 31.72±5.42; p˂0.01). The average HbA1c in 2018 was higher than ten years ago (7.28% +/- 1.23% vs. 7.76% +/- 1.39; p˂0.01). The rate of patients with an HbA1c level below 7% was higher than the average in 2018 (7.92 +/- 1.28 vs. 8.32 +/- 1.37; p˂0.001). Glomerular filtration rates (GFR) were found to be significantly higher in 2011 than in 2018 (111.5 +/- 34.5 vs. 102.1 +/- 32.3; p˂0.001). Albumin/creatinine (ACR) average was found to be significantly higher in 2018 (61 +/- 174 mg vs. 105 +/- 253; p: 0.003). LDL cholesterol and non-HDL cholesterol averages were found to be significantly higher in 2018. The rate of insulin use was higher in 2018 (24% vs. 39%, p˂0.001; 25% vs. 40%, p˂0.001). No significant change was determined in metformin use whereas there was a significant decrease in sulphonylurea use in 2018 (34% vs. 19%, p˂0.001). There was a significant increase in gliclazide use (7% vs. 12%, p: 0.018). A significant decrease was observed in the use of pioglitazone, glinide, and acarbose in 2018 whereas there was a significant increase in the use of DPP4-I (1% vs. 44%, p˂0.001). No comparison could be made for the use of SGLT-2 group, which was not yet in use ten years ago. Conclusion: Diabetic targets, BMI, lipid targets, and renal functions were worsened in T2DM patients in 2018 compared to ten years ago. The rate of metformin use did not change; the use of sulphonylurea, PIO, and acarbose decreased; the use of DPP4-I increased. The increase in the rate of insulin use and doses is noteworthy.