Achieving the goals in treatment of patients with diabetes mellitus in Ukraine. Results of the International Diabetes Management Practices Study (IDMPS)

Abstract

Rationale and purpose. Complications of diabetes mellitus are one of the main causes of lethality in Ukraine. The aim of this analysis was to study the characteristics of  management of patients with diabetes mellitus (DM) in Ukraine and to achieve their goals of treatment. Methods. The authors have analyzed the data on Ukrainian  patients with T1DM and T2DM included in the 5th and 6th wave of the International Diabetes Management Practices Study (IDMPS). Results. In Ukraine, 592 patients  with DM were included in the 2011 study (5th wave of IDMPS) and 600 patients in 2014 (6th wave of IDMPS). In 2011 (5th wave of IDMPS) 202/353 (57.2%) patients with  T2DM were treated with oral hypoglycemic agents (OHGA) only; 58/353 (16.4%) only with insulin; 91/353 (25.8%) received OHGA and insulin; 2/353 (0.6%) were on diet  and exercise. The vast majority of patients with T1DM (95.5%) received insulin and 4.5% insulin in combination with OHGA. In 2014 (6th wave of IDMPS) 176/389  (45.2%) patients with T2DM were treated only with OHGA; 85/389 (21.9%) only with insulin; 127/389 (32.6%) received OHGA and insulin; 1/389 (0.3%) were on diet and  exercise. The vast majority of patients with T1DM (99.1%) in 2014 received insulin and 0.9% insulin in combination with OHGA. The level of glycated hemoglobin  (HbA1c) in 2011 was tested at least once in 97.5% of patients with T1DM and in 85.3% of T2DM patients. In 2014, HbA1c level was tested at least once in 98.6% of patients with T1DM and in 95.3% of T2DM patients. In the 5th wave of IDMPS only 15.5% of patients with T1DM and 15.4% of patients with T2DM achieved the recommended rate of HbA1c <7%. Those patients with T2DM who received only OHGA achieved a better glycemic control. In the 6th wave of IDMPS only 13.5% of  patients with T1DM and 12.8% of patients with T2DM achieved the recommended rate of HbA1c <7%. Those patients with T2DM who received only OHGA achieved a  better glycemic control (24.5% of patients with a HbA1c <7%) compared with patients who were treated with OHGA and insulin (4.8%) or only insulin (1.3%).