Meeting dual HbA1c and LDL-C goals improves diabetes care

July 9, 2013

Meeting dual HbA1c & LDL-C goals improves diabetes care
Dual achievement of both glycated hemoglobin and low-density lipoprotein cholesterol goals among patients with diabetes is associated with greater clinical and economic benefit than achievement of either goal alone, according to a study published online June 25 in Diabetes Care.
(HealthDay)—Dual achievement of both glycated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C) goals among patients with diabetes is associated with greater clinical and economic benefit than achievement of either goal alone, according to a study published online June 25 in Diabetes Care.

Lizheng Shi, Ph.D., from Tulane University in New Orleans, and colleagues retrospectively evaluated from 75,646 adult patients with 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 (adjusted hazard ratio [aHR], 0.79), acute coronary syndrome (0.88), percutaneous coronary intervention (0.78), and (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.

Explore further: Fasting plasma glucose beats HbA1c for diabetes screening

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gaucho25
not rated yet Jul 09, 2013
This new FDA approve diet pill has a dramatic effect on diabetes.

ADA Poster Presentation Abstract from the June Chicago convention
Lorcaserin, (Belviq) a selective 5-HT2C agonist, was recently approved for weight management in conjunction with lifestyle modification in obese patients (BMI ≥30) and overweight patients (BMI ≥27) with at least one co-morbidity. In patients without diabetes, proportions achieving ≥5% weight loss and absolute weight loss at Week (W)52 for lorcaserin vs. placebo were 47 vs. 23% and 5.8 vs. 2.5kg respectively (MITT-LOCF). In patients with type 2 diabetes mellitus (T2DM) results were 38 vs.16% and 4.7 vs.1.6kg respectively.

To limit exposure and maximize benefit the predictive value for >5% W52 weight loss was assessed at W12. Patients not losing at least 5% at W12 (non-responders) should be discontinued.

Proportions of responders without diabetes lorcaserin vs. placebo were 49.3 vs. 22.6%. W52 weight loss in lorcaserin responders without diabetes was 10.6kg (23 lbs) with 86% and 50% achieving at least 5% and 10% weight loss respectively.

Proportions of responders with T2DM lorcaserin vs. placebo were 35.9 vs. 11.5%. W52 weight loss in lorcaserin responders with T2DM was 9.3kg (20 lbs) with 71% and 36% achieving 5% and 10% weight loss. W52 reductions in FPG and A1C in lorcaserin responders with T2DM were 29.3mg/dL and 1.2%. W52 reductions in systolic and diastolic BP and heart rate were 3.4mmHg 2.5mmHg and 2.5BPM in lorcaserin responders without diabetes and 2.6mmHg 1.9mmHg and
3.2BPM in lorcaserin responders with T2DM.

Achievement of ≥5% weight loss by W12 is a strong predictor of robust one-year lorcaserin responses in weight cardiovascular vital signs and glycemia.

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