OBJECTIVES : Achieving glycaemic control is important in reducing the risk of micro- and macrovascular complications in type 2 diabetes mellitus (T2DM) patients, and has been a main focus within the GP network Zorggroep ZGWA. The objective of the current study was to evaluate glycaemic control of T2DM patients within the ZGWA, stratified by treatment regimen.

METHODS : The Dutch HbA1c targets are 53, 58 or 64 mmol/mol, depending on age, treatment intensity and diabetes duration. Treatment was categorized as no medicinal treatment, oral anti-diabetic drugs (OADs), GLP-1ra and various insulin regimens. Per treatment category, proportions at target, below target and <54 mmol/mol, and above target and >64 mmol/mol were determined. Subgroup analyses were performed according to gender and BMI.

RESULTS : 14.184 patients with T2DM were identified, of whom 53% were male and 41% had a BMI ≥ 30 kg/m2. Overall goal attainment was 57%, with lower average scores within more intense treatment regimens. 64% of patients without medicinal treatment achieved their HbA1c target, 44-59% with OADs, 45% with GLP-1ra, 36% with basal insulin, and 40-57% with multiple daily insulin regimens. In those patients with a glycaemic target of 53 or 58 mmol/mol, 15% had an HbA1c >64 mmol/mol (ranging from 10% with metformin monotherapy to 49% with basal-bolus insulin). In those patients with a glycaemic target of 58 or 64 mmol/mol, 36% had an HbA1c < 54 mmol/mol, ranging from 21% with basal insulin to 50% with GLP-1ra). Goal attainment was similar in males versus females (56% versus 58% respectively) but lower in patients with a BMI ≥ 30 kg/m2 versus BMI < 30 kg/m2 (53% versus 60% respectively).

CONCLUSIONS : Many T2DM patients achieve glycaemic control according to their individualized HbA1c targets. A deep understanding of real-world outcomes allows the GP network to further optimize T2DM therapies in their population.