PMID- 18976457
OWN - NLM
STAT- MEDLINE
DCOM- 20090127
LR  - 20221207
IS  - 1477-7525 (Electronic)
IS  - 1477-7525 (Linking)
VI  - 6
DP  - 2008 Oct 31
TI  - Outcomes of adding second hypoglycemic drug after metformin monotherapy failure 
      among type 2 diabetes in Hungary.
PG  - 88
LID - 10.1186/1477-7525-6-88 [doi]
AB  - AIM: The objective of this observational study was to assess the status of 
      glycemic control and associated patient-reported outcomes in ambulatory Hungarian 
      patients with type 2 diabetes mellitus (T2DM) who were prescribed either a 
      sulfonylurea (SU) or a thiazolidinedione (TZD) in addition to the prior metformin 
      (MF) monotherapy. METHODS: Type 2 diabetics aged > or = 30 years and who had 
      added an SU or TZD to previous MF monotherapy at least 1 year prior to the visit 
      date were identified during January 2006 to March 2007. Information on HbA1c 
      (A1C), medication use and co-morbid conditions was extracted from the medical 
      record up to 6 months prior to the addition of SU or TZD to MF (baseline), and a 
      minimum of one year after the initiation of either SU or TZD. Glycemic control 
      (A1C < 6.5%) was assessed using the last available A1C value in the medical 
      record. Self-reported hypoglycemia, health-related quality of life (HRQoL) and 
      treatment satisfaction were also assessed. RESULTS: A total of 414 patients (82% 
      SU+MF and 18% TZD+MF) with a mean age of 60.5 years (SD = 9.4 years) participated 
      in the study. About 27% of patients reported hypoglycemic episodes, with about 
      one-third reporting episodes that resulted into interruption of activities or 
      required medical/non-medical assistance. Three quarters of patients were not at 
      glycemic goal and BMI was the only factor significantly associated with failure 
      to have an A1C level < 6.5%. Patients' HRQoL was significantly associated with 
      self-reported hypoglycemic episodes (p = 0.017), and duration of diabetes (p = 
      0.045). CONCLUSION: Nearly 75% of patients were not at A1C goal of < 6.5% despite 
      using two oral anti-hyperglycemic medications. Approximately 9% of patients 
      reporting hypoglycemia required some kind of medical/non-medical assistance. 
      Greater BMI at baseline was associated with an A1C level > or = 6.5%. Finally, 
      self- reports of hypoglycemia and duration of diabetes were associated with low 
      HRQoL.
FAU - Jermendy, Gyorgy
AU  - Jermendy G
AD  - The Ohio State University, Columbus, OH 43210, USA. not@valid.com
CN  - Hungarian RECAP Group
FAU - Erdesz, Diana
AU  - Erdesz D
FAU - Nagy, Laszlo
AU  - Nagy L
FAU - Yin, Don
AU  - Yin D
FAU - Phatak, Hemant
AU  - Phatak H
FAU - Karve, Sudeep
AU  - Karve S
FAU - Engel, Samuel
AU  - Engel S
FAU - Balkrishnan, Rajesh
AU  - Balkrishnan R
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20081031
PL  - England
TA  - Health Qual Life Outcomes
JT  - Health and quality of life outcomes
JID - 101153626
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Sulfonylurea Compounds)
RN  - 0 (Thiazolidinediones)
RN  - 9100L32L2N (Metformin)
RN  - AA68LXK93C (2,4-thiazolidinedione)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Diabetes Mellitus, Type 2/*drug therapy/physiopathology
MH  - Drug Therapy, Combination
MH  - Female
MH  - Glycated Hemoglobin/drug effects
MH  - Humans
MH  - Hungary
MH  - Hypoglycemia/chemically induced
MH  - Hypoglycemic Agents/adverse effects/*therapeutic use
MH  - Male
MH  - Metformin/adverse effects/*therapeutic use
MH  - Middle Aged
MH  - Patient Satisfaction/*statistics & numerical data
MH  - Quality of Life
MH  - Sickness Impact Profile
MH  - Sulfonylurea Compounds/adverse effects/*therapeutic use
MH  - Thiazolidinediones/adverse effects/*therapeutic use
MH  - Treatment Failure
MH  - *Treatment Outcome
PMC - PMC2600631
EDAT- 2008/11/04 09:00
MHDA- 2009/01/28 09:00
PMCR- 2008/10/31
CRDT- 2008/11/04 09:00
PHST- 2008/07/01 00:00 [received]
PHST- 2008/10/31 00:00 [accepted]
PHST- 2008/11/04 09:00 [entrez]
PHST- 2008/11/04 09:00 [pubmed]
PHST- 2009/01/28 09:00 [medline]
PHST- 2008/10/31 00:00 [pmc-release]
AID - 1477-7525-6-88 [pii]
AID - 10.1186/1477-7525-6-88 [doi]
PST - epublish
SO  - Health Qual Life Outcomes. 2008 Oct 31;6:88. doi: 10.1186/1477-7525-6-88.