PMID- 38028982
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231201
IS  - 2673-6616 (Electronic)
IS  - 2673-6616 (Linking)
VI  - 4
DP  - 2023
TI  - HbA1c control in type 2 diabetes mellitus patients with coronary artery disease: 
      a retrospective study in a tertiary hospital in South Africa.
PG  - 1258792
LID - 10.3389/fcdhc.2023.1258792 [doi]
LID - 1258792
AB  - BACKGROUND: Type 2 diabetes mellitus (T2DM) patients with coronary artery disease 
      (CAD) have an increased risk of recurrent cardiovascular events. These patients 
      require optimal glucose control to prevent the progression of atherosclerotic 
      cardiovascular disease (ASCVD). Contemporary guidelines recommend an HbA1c </=7% to 
      mitigate this risk. The aim of this study was to evaluate HbA1c control in T2DM 
      patients with angiographically proven ASCVD. METHODS: We conducted a 
      cross-sectional, retrospective study on consecutive T2DM patients with acute and 
      chronic coronary syndromes managed in a tertiary academic hospital in South 
      Africa. Glycaemic control was assessed by evaluating the glycated haemoglobin 
      (HbA1c) level measured at index presentation with acute and chronic coronary 
      syndromes and during the most recent follow-up visit. RESULTS: The study 
      population comprised 262 T2DM patients with a mean age of 61.3 +/- 10.4 years. At 
      index presentation, 110 (42.0%) T2DM patients presented with ST-segment elevation 
      myocardial infarction, 69 (26.3%) had non-ST-segment elevation myocardial 
      infarction, 43 (16.4%) had unstable angina, and 40 (15.3%) had stable angina. 
      After a median duration of 16.5 months (IQR: 7-29), 28.7% of the study 
      participants had an HbA1c </=7%. On multivariable logistic regression analysis, 
      females were less likely to have poor glycaemic control (HbA1c above 7%) [odds 
      ratio (OR): 0.42, 95% confidence interval (CI): 0.19-0.95, p=0.038]. Also, T2DM 
      patients prescribed metformin monotherapy (OR: 0.34, 95% CI: 0.14-0.82, p=0.017) 
      and patients with ST-segment depression on the electrocardiogram (OR: 0.39, 95% 
      CI: 0.16-0.96, p=0.041) were less likely to have poor glycaemic control. 
      CONCLUSION: After a median duration of 16.5 months, only 28.7% of T2DM patients 
      with CAD had an HbA1c </=7%. This finding underscores the substantial unmet need 
      for optimal diabetes control in this very high-risk group.
CI  - Copyright (c) 2023 Mhlaba, Mpanya and Tsabedze.
FAU - Mhlaba, Lona
AU  - Mhlaba L
AD  - Division of Cardiology, Department of Internal Medicine, School of Clinical 
      Medicine, Faculty of Health Sciences, University of the Witwatersrand and the 
      Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
FAU - Mpanya, Dineo
AU  - Mpanya D
AD  - Division of Cardiology, Department of Internal Medicine, School of Clinical 
      Medicine, Faculty of Health Sciences, University of the Witwatersrand and the 
      Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
FAU - Tsabedze, Nqoba
AU  - Tsabedze N
AD  - Division of Cardiology, Department of Internal Medicine, School of Clinical 
      Medicine, Faculty of Health Sciences, University of the Witwatersrand and the 
      Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
LA  - eng
PT  - Journal Article
DEP - 20231030
PL  - Switzerland
TA  - Front Clin Diabetes Healthc
JT  - Frontiers in clinical diabetes and healthcare
JID - 9918266295306676
PMC - PMC10645148
OTO - NOTNLM
OT  - Africa
OT  - HbA1c
OT  - coronary artery disease
OT  - diabetes mellitus
OT  - glucose control
COIS- NT has received consulting and speaker fees from Acino Health Care Group, 
      Boehringer-Ingelheim, Boston Scientific, Eli Lilly, Merck, Novartis 
      Pharmaceuticals, Novo Nordisk, Organon, Pfizer, Phillips, Servier, and Takeda. NT 
      has also received educational grants from Biotronik, Boston Scientific, 
      Medtronic, and Vertice Health Care Group. The remaining authors declare that the 
      research was conducted in the absence of any commercial or financial 
      relationships that could be construed as a potential conflict of interest.
EDAT- 2023/11/29 18:42
MHDA- 2023/11/29 18:43
PMCR- 2023/10/30
CRDT- 2023/11/29 17:20
PHST- 2023/07/14 00:00 [received]
PHST- 2023/10/16 00:00 [accepted]
PHST- 2023/11/29 18:43 [medline]
PHST- 2023/11/29 18:42 [pubmed]
PHST- 2023/11/29 17:20 [entrez]
PHST- 2023/10/30 00:00 [pmc-release]
AID - 10.3389/fcdhc.2023.1258792 [doi]
PST - epublish
SO  - Front Clin Diabetes Healthc. 2023 Oct 30;4:1258792. doi: 
      10.3389/fcdhc.2023.1258792. eCollection 2023.