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Exp Clin Endocrinol Diabetes 2018; 126(01): 53-60
DOI: 10.1055/s-0043-109242
Article
© Georg Thieme Verlag KG Stuttgart · New York

The Real-Life Effectiveness and Care Patterns of Type 2 Diabetes Management in Greece

Emmanuel Pagkalos
1   Department of Diabetes, Clinic “Thermi”, Thessaloniki, Greece
,
Anastasia Thanopoulou
2   Second Department of Internal Medicine, General Hospital “Hippocratio”, National and Kapodistrian University, Athens, Greece
,
Christos Sampanis
3   Diabetes Centre, Second Propaedeutic Department of Internal Medicine “Hippocratio”, Thessaloniki, Greece
,
Stavros Bousboulas
4   Diabetes Centre, General Hospital “Ag. Panteleimon”, Piraeus, Greece
,
Andreas Melidonis
5   Diabetes Centre, General Hospital “Tzanio”, Piraeus, Greece
,
Nicholas Tentolouris
6   First Propaedeutic Department of Internal Medicine, General Hospital “Laiko”, National and Kapodistrian University, Athens, Greece
,
Theodoros Alexandrides
7   Department of Endocrinology, University General Hospital of Patras, Rion, Greece
,
Ilias Migdalis
8   Second Medical Department and Diabetes Centre, NIMTS Hospital, Greece
,
Eugenia Karamousouli
9   Merck Sharp & Dohme Pharmaceutical, Industrial and Commercial S.A, Athens, Greece
,
Nikolaos Papanas
10   Diabetes Centre, Second Department of Internal Medicine, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
› Author Affiliations
Further Information

Publication History

received 07 March 2017
revised 09 April 2017

accepted 19 April 2017

Publication Date:
13 July 2017 (online)

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Abstract

Aim To investigate the prevalence of hypoglycaemia during sulfonylurea (SU) treatment of type 2 diabetes mellitus (T2DM) in Greece and its influence on glycaemic control, treatment adherence and quality of life (QoL).

Patients and methods This was a retrospective cross-sectional study. We included 383 T2DM patients ≥30 years old on treatment with SU in monotherapy or in combination with metformin for at least 6 months. Patients were requested to fill in retrospective questionnaires on hypoglycaemia experience, adherence, weight gain and lifestyle/behavioural factors along with QoL (EQ-5D-3L), treatment satisfaction (TSQM), and fear of hypoglycaemia (HFS-II Worry scale).

Results HbA1c<7% was found in 161 (42.0%) patients. In total, 165 (43.1%) patients reported hypoglycaemic symptoms during the previous 6 months: 41.6% (67/161) of those with HbA1c <7% and 44.1% (98/222) of those with HbA1c ≥7%. Glycaemic control was achieved by 43.1% (94/218) of patients without hypoglycaemia and 50.0% (41/82), 36.8% (25/68) and 6.7% (1/15) of patients with mild, moderate or severe hypoglycaemia, respectively (p=0.013). In multivariate analysis, both occurrence (none vs. mild/moderate/severe) and severity (none vs. mild vs. moderate vs. severe) of hypoglycaemia were significantly associated with impaired global treatment satisfaction (p=0.002 and p<0.0001 respectively) and HFS-II Worry scale scores (both p<0.0001), while lower QoL (EQ-5D (UK) Index) was related to hypoglycaemia severity (p=0.024) only. Finally, treatment adherence was associated with increased (none/mild vs. moderate/severe) hypoglycaemia severity in univariate analysis (p=0.019).

Conclusion A high prevalence of patient treated with SU reported hypoglycaemia in Greek healthcare settings with negative effects on treatment satisfaction, patient worry and adherence. Severity of hypoglycaemic symptoms was associated with reduced glycaemic control.

Key words

type 2 diabetes - sulfonylurea - hypoglycaemia - therapy outcome
 

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