Meeting dual HbA1c and LDL-C goals improves diabetes care
Lizheng Shi, Ph.D., from Tulane University in New Orleans, and colleagues retrospectively evaluated electronic medical records from 75,646 adult patients with type 2 diabetes mellitus with two or more measurements of LDL-C and HbA1c from Jan. 1, 2004, to June 30, 2010. Microvascular and cardiovascular outcomes were compared by goal achievement status. Diabetes-related resource utilization was assessed via hospitalization days and number of outpatient visits and medical service costs.
The researchers found that dual-goal achievement was associated with lower risk of microvascular complications (adjusted hazard ratio [aHR], 0.79), acute coronary syndrome (0.88), percutaneous coronary intervention (0.78), and coronary artery bypass graft (CABG; 0.74), compared to achievement of only the LDL-C goal. Dual-goal achievement was also associated with fewer hospitalization days (adjusted incidence rate ratio [aIRR], 0.93) and outpatient visits (0.88), as well as lower diabetes-related annual medical costs (?$130.89). Dual-goal achievement was associated with lower risk of the composite cardiovascular-related end point (aHR, 0.87) and CABG (aHR, 0.62), and fewer outpatient visits (aIRR, 0.98), compared to achievement of only the HbA1c goal.
"Achieving both HbA1c and LDL-C goals in diabetes care is associated with additional clinical and economic benefits, as compared with the achievement of either goal alone," the authors write.
Several authors disclosed financial ties to Daiichi Sankyo, which sponsored the study.
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