Irving, R.R.; Mills, James L.; Choo-Kang, Eric G.; Mullings, Anthony; Morrison, E.Y.; Wright-Pascoe, Rosemarie; McLaughlin, Wayne
Author Affiliation, Ana.
Glycemic control in patients with early onset autosomal dominant type 2 diabetes.
International Journal of Medicine
Date of Publication
Background : Many studies support a correlation between glycemic control and diabetes complications in patients with type 2 diabetes. Epidemiological analysis showed a continuum between risk of cardiovascular complications and glycemia, so that for each percentage point decrease in HbA1c there was a twenty five percent reduction in diabetes related death. Studies showed that persons affected by diabetes who understand the risk for, and implications of the complications of the disease are more likely to have better glycemic control and outcome. Aim : To determine the levels of glycemic control in persons with early onset autosomal dominant type 2 diabetes. Methods : Eighty nine affected individuals from families with early onset autosomal dominant type 2 diabetes were assessed for levels of glycemic control. Glycemic control each three months, for a period of twelve months was monitored by HbA1c. Patient’s demographic and anthropometric data, adherence to treatment plan and attendance patterns at clinics were also assessed. Results: The significant changes in mean HbA1c in the 89 affected individuals from baseline to 12 months followed a linear pattern ( 12.3± 1.2% at 0 month , 12.3±1.6% at 3 months, 12.0±1.0% at 6 months, 11.7±0.9% at 9 months, 11.4±1.7% at 12 months, p <0.005). There was no statistically significant difference in HbA1c from baseline to 12 months for the different patterns of adherence to treatment plan however those with excellent adherence to treatment had a steeper decreased in HbA1c from baseline to 12 months (excellent adherence: HbA1c decreased 1.9% over 12 months, poor adherence : HbA1c decreased 1.08 % over 12 months). There was no statistically significant difference in HbA1c between those with poor or moderate patterns of attendance at clinics however when the comparison was made between those with poor and excellent attendance, the statistical difference was significant (p<0.05). Patients with excellence attendance had the greatest decreased in HbA1c from baseline to 12 months (12.2±4.4% at baseline to 8.9±3.0% at 12 months, p <0.05). Conclusion: Adherence to treatment plan and attendance at clinics enhance reduction in HbA1c.....