Prevalence of Hypoglycemia, Treatment Satisfaction, Adherence and Their Associations with Glycemic Goals in Patients with Type 2 Diabetes Mellitus Treated with Sulfonylureas: Findings from the Real-Life Effectiveness and Care Patterns of Diabetes Management (RECAP-DM) in Romania

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Background and aims: The aim of this study was to assess the prevalence and evaluate the impact on several treatment and quality of life parameters of hypoglycemia in type 2 diabetes mellitus patients treated with sulfonylureas (SU) in Romania. Secondary objective was to determine the proportion of patients attaining haemoglobin A1c (HbA1c) target of <7%.

Material and method: This was a multi-center, observational study using retrospective clinical chart and laboratory parameters review, and a cross-sectional survey in Romania. The sample in this study consisted of 385 patients. Socio-demographic and clinical variables were compared between patients with inadequate and adequate control.

Results: The mean age of all enrolled subjects was 65.37 (33-87) years. The average BMI was 30.44 kg/m2. Mean diabetes duration was 7.76 (6 months -32) years with the mean age of diabetes at diagnosis of 57.75 (31-85) years. HbA1c was recorded for 238 subjects with mean value of 7.12 (4.8-10.97) %.

Conclusions: The prevalence of hypoglycaemia in SU treated patients was 42.2%. Highest prevalence was in the 50-60 age category, at 49.2% and lowest among the eldest subjects (>70 years), at 38.6%. Prevalence of patients at the goal of HbA1c<7% was 50.8 %. Patients with adequate glycaemic control had more acceptable BMI than those with inadequate glycaemic control. In patients not achieving a goal of HbA1c < 7%, higher level of plasma glucose and total cholesterol was determined compared to those with adequate glycaemic control. There were no significant differences in the HDL-C, triglycerides or albumin:creatinine ratios in patients with both adequate and inadequate glycaemic control.

1. International Diabetes Federation (IDF). IDF Diabetes Atlas. [online]. Available at: [Accessed Nov 1st, 2018].

2. Roglic G, Unwin N, Bennett PH et al. The burden of mortality attributable to diabetes: realistic estimates for the year 2000. Diabetes Care 2005; 28: 2130–2135

3. Gerich JE. The importance of tight glycemic control. Am J Med 2005; 118: 7S–11S

4. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014; 103: 137–49.

5. Mota M, Dinu I. The analysis of prevalence and incidence of diabetes mellitus in Romania. Rom J. Diabetes Nutr Metab Dis. 2013; 20: 135–9

6. Mota M, Popa SG, Mota E et al. Prevalence of diabetes mellitus and prediabetes in the adult Romanian population: PREDATORR study. J Diabetes. 2016;8(3):336-44.

7. Davies MJ, D'Alessio DA, Fradkin J et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Diabetes Care. 2018 Oct 4. pii: dci180033. doi: 10.2337/dci18-0033.

8. International Diabetes Federation Working Group. IDF Clinical Practice Recommendations for managing Type 2 Diabetes in Primary Care [online]. Available at [Accessed Nov 1st, 2018]

9. Diabetes Control and Complications Trial (DCCT). Adverse events and their association with treatment regimens in the diabetes control and complications trial. Diabetes Care. Nov 1995;18(11):1415-1427.

10. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. Aug 12 2000;321(7258): 405-412.

11. Lundkvist J, Berne C, Bolinder B, Jonsson L. The economic and quality of life impact of hypoglycemia. Eur J Health Econ. Sep 2005;6(3):197-202.

12. Vexiau P, Mavros P, Krishnarajah G, Lyu R, Yin D. Hypoglycaemia in patients with type 2 diabetes treated with a combination of metformin and sulphonylurea therapy in France. Diabetes Obes Metab. Jun 2008;10 Suppl 1:16-24.

13. Davis RE, Morrissey M, Peters JR, Wittrup-Jensen K, Kennedy-Martin T, Currie CJ. Impact of hypoglycaemia on quality of life and productivity in type 1 and type 2 diabetes. Curr Med Res Opin. Sep 2005;21(9):1477-1483.

14. Chan SP, Ji LN, Nitiyanant W, Baik SH, Sheu WH. Hypoglycemic symptoms in patients with type 2 diabetes in Asia-Pacific-Real-life effectiveness and care patterns of diabetes management: the RECAP-DM study. Diabetes Res Clin Pract. Aug;89(2):e30-32.

15. Alvarez Guisasola F, Tofe Povedano S, Krishnarajah G, Lyu R, Mavros P, Yin D. Hypoglycaemic symptoms, treatment satisfaction, adherence and their associations with glycaemic goal in patients with type 2 diabetes mellitus: findings from the Real-Life Effectiveness and Care Patterns of Diabetes Management (RECAP-DM) Study. Diabetes Obes Metab. 2008;10 Suppl 1:25-32.

16. The Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of Intensive Glucose Lowering in Type 2 Diabetes. NEJM Vol 358; 2008:2545-2559.

17. Duckworth W, Abraira C, Moritz T, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360(2):129-139.

18. Patel A, MacMahon S, Chalmers J, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560-2572.

19. Tubiana-Rufi N and Du Pasquier-Fediaevsky L. Le concept d’adhésion au traitement du diabète revisité. Diabetes and Metabolism (Paris) 1999; 25: 172-6

20. McIntosh A, Feder G, Hutchinson A, Durrington P, Elkeles R, Hitman GA et al. Clinical guidelines and evidence review for type 2 diabetes: Lipids Management. Sheffield: ScHARR, University of Sheffield, 2001

Romanian Journal of Diabetes Nutrition and Metabolic Diseases

The Journal of Romanian Society of Diabetes Nutrition and Metabolic Diseases

Journal Information

CiteScore 2018: 0.19

SCImago Journal Rank (SJR) 2018: 0.128
Source Normalized Impact per Paper (SNIP) 2018: 0.229


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