Achievement of therapeutic targets in patients with diabetes and chronic kidney disease: Insights from the Associazione Medici Diabetologi Annals initiative

Salvatore De Cosmo, Francesca Viazzi, Antonio Pacilli, Carlo Giorda, Antonio Ceriello, Sandro Gentile, Giuseppina Russo, Maria Chiara Rossi, Antonio Nicolucci, Pietro Guida, Paolo Di Bartolo, Roberto Pontremoli

Research output: Contribution to journalArticle

Abstract

Background Chronic kidney disease (CKD) entails a worse cardiovascular outcome. The aim of our work was to study the relationship between CKD and the achievement of recommended targets for glycated haemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-c) and blood pressure (BP) in a real-life sample of patients with type 2 diabetes mellitus (T2DM). Methods We analysed a sample of 116 777 outpatients from the Network of the Italian Association of Clinical Diabetologists; all patients had T2DM and at least one measurement of HbA1c, LDL-c, BP, serum creatinine and albuminuria in the year 2010. The outcome was the achievement of HbA1c, LDL-c and BP values as recommended by International Guidelines. Results In the entire sample, the mean value of HbA1c was 7.2 ± 1.2%, of LDL-c was 102 ± 33 mg/dL and of BP was 138/78 ± 19/9 mmHg. CKD and its components were associated with poor glycaemic and BP control, notwithstanding greater use of glucose and BP-lowering drugs, while no association was found with LDL-c values. Factors independently related to unsatisfactory glycaemic control included female gender, body mass index, duration of disease and high albuminuria. Men, older people and those taking statins were more likely to reach LDL-c target levels. Male gender, age and high albuminuria strongly affected the achievement of BP targets. Conclusions CKD or its components, mainly high albuminuria, are associated with failure to reach therapeutic targets, especially for HbA1c and BP, despite a greater use of drugs in patients with T2DM.

Original languageEnglish
Pages (from-to)1526-1533
Number of pages8
JournalNephrology Dialysis Transplantation
Volume30
Issue number9
DOIs
Publication statusPublished - Sep 1 2015

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Chronic Renal Insufficiency
LDL Cholesterol
Blood Pressure
Albuminuria
Type 2 Diabetes Mellitus
Therapeutics
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Glycosylated Hemoglobin A
Pharmaceutical Preparations
Creatinine
Body Mass Index
Outpatients
Guidelines
Glucose
Serum

Keywords

  • Antihypertensive treatment
  • arterial hypertension
  • cardiovascular risk factors
  • diabetic nephropathy
  • hypercholesterolaemia

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Achievement of therapeutic targets in patients with diabetes and chronic kidney disease : Insights from the Associazione Medici Diabetologi Annals initiative. / De Cosmo, Salvatore; Viazzi, Francesca; Pacilli, Antonio; Giorda, Carlo; Ceriello, Antonio; Gentile, Sandro; Russo, Giuseppina; Rossi, Maria Chiara; Nicolucci, Antonio; Guida, Pietro; Di Bartolo, Paolo; Pontremoli, Roberto.

In: Nephrology Dialysis Transplantation, Vol. 30, No. 9, 01.09.2015, p. 1526-1533.

Research output: Contribution to journalArticle

De Cosmo, Salvatore ; Viazzi, Francesca ; Pacilli, Antonio ; Giorda, Carlo ; Ceriello, Antonio ; Gentile, Sandro ; Russo, Giuseppina ; Rossi, Maria Chiara ; Nicolucci, Antonio ; Guida, Pietro ; Di Bartolo, Paolo ; Pontremoli, Roberto. / Achievement of therapeutic targets in patients with diabetes and chronic kidney disease : Insights from the Associazione Medici Diabetologi Annals initiative. In: Nephrology Dialysis Transplantation. 2015 ; Vol. 30, No. 9. pp. 1526-1533.
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abstract = "Background Chronic kidney disease (CKD) entails a worse cardiovascular outcome. The aim of our work was to study the relationship between CKD and the achievement of recommended targets for glycated haemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-c) and blood pressure (BP) in a real-life sample of patients with type 2 diabetes mellitus (T2DM). Methods We analysed a sample of 116 777 outpatients from the Network of the Italian Association of Clinical Diabetologists; all patients had T2DM and at least one measurement of HbA1c, LDL-c, BP, serum creatinine and albuminuria in the year 2010. The outcome was the achievement of HbA1c, LDL-c and BP values as recommended by International Guidelines. Results In the entire sample, the mean value of HbA1c was 7.2 ± 1.2{\%}, of LDL-c was 102 ± 33 mg/dL and of BP was 138/78 ± 19/9 mmHg. CKD and its components were associated with poor glycaemic and BP control, notwithstanding greater use of glucose and BP-lowering drugs, while no association was found with LDL-c values. Factors independently related to unsatisfactory glycaemic control included female gender, body mass index, duration of disease and high albuminuria. Men, older people and those taking statins were more likely to reach LDL-c target levels. Male gender, age and high albuminuria strongly affected the achievement of BP targets. Conclusions CKD or its components, mainly high albuminuria, are associated with failure to reach therapeutic targets, especially for HbA1c and BP, despite a greater use of drugs in patients with T2DM.",
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T1 - Achievement of therapeutic targets in patients with diabetes and chronic kidney disease

T2 - Insights from the Associazione Medici Diabetologi Annals initiative

AU - De Cosmo, Salvatore

AU - Viazzi, Francesca

AU - Pacilli, Antonio

AU - Giorda, Carlo

AU - Ceriello, Antonio

AU - Gentile, Sandro

AU - Russo, Giuseppina

AU - Rossi, Maria Chiara

AU - Nicolucci, Antonio

AU - Guida, Pietro

AU - Di Bartolo, Paolo

AU - Pontremoli, Roberto

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Background Chronic kidney disease (CKD) entails a worse cardiovascular outcome. The aim of our work was to study the relationship between CKD and the achievement of recommended targets for glycated haemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-c) and blood pressure (BP) in a real-life sample of patients with type 2 diabetes mellitus (T2DM). Methods We analysed a sample of 116 777 outpatients from the Network of the Italian Association of Clinical Diabetologists; all patients had T2DM and at least one measurement of HbA1c, LDL-c, BP, serum creatinine and albuminuria in the year 2010. The outcome was the achievement of HbA1c, LDL-c and BP values as recommended by International Guidelines. Results In the entire sample, the mean value of HbA1c was 7.2 ± 1.2%, of LDL-c was 102 ± 33 mg/dL and of BP was 138/78 ± 19/9 mmHg. CKD and its components were associated with poor glycaemic and BP control, notwithstanding greater use of glucose and BP-lowering drugs, while no association was found with LDL-c values. Factors independently related to unsatisfactory glycaemic control included female gender, body mass index, duration of disease and high albuminuria. Men, older people and those taking statins were more likely to reach LDL-c target levels. Male gender, age and high albuminuria strongly affected the achievement of BP targets. Conclusions CKD or its components, mainly high albuminuria, are associated with failure to reach therapeutic targets, especially for HbA1c and BP, despite a greater use of drugs in patients with T2DM.

AB - Background Chronic kidney disease (CKD) entails a worse cardiovascular outcome. The aim of our work was to study the relationship between CKD and the achievement of recommended targets for glycated haemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-c) and blood pressure (BP) in a real-life sample of patients with type 2 diabetes mellitus (T2DM). Methods We analysed a sample of 116 777 outpatients from the Network of the Italian Association of Clinical Diabetologists; all patients had T2DM and at least one measurement of HbA1c, LDL-c, BP, serum creatinine and albuminuria in the year 2010. The outcome was the achievement of HbA1c, LDL-c and BP values as recommended by International Guidelines. Results In the entire sample, the mean value of HbA1c was 7.2 ± 1.2%, of LDL-c was 102 ± 33 mg/dL and of BP was 138/78 ± 19/9 mmHg. CKD and its components were associated with poor glycaemic and BP control, notwithstanding greater use of glucose and BP-lowering drugs, while no association was found with LDL-c values. Factors independently related to unsatisfactory glycaemic control included female gender, body mass index, duration of disease and high albuminuria. Men, older people and those taking statins were more likely to reach LDL-c target levels. Male gender, age and high albuminuria strongly affected the achievement of BP targets. Conclusions CKD or its components, mainly high albuminuria, are associated with failure to reach therapeutic targets, especially for HbA1c and BP, despite a greater use of drugs in patients with T2DM.

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KW - arterial hypertension

KW - cardiovascular risk factors

KW - diabetic nephropathy

KW - hypercholesterolaemia

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