OBJECTIVES : Large studies have shown that maintaining glycemic control with HbA1c below 7% prevents or delays the development of micro and macrovascular complications, but despite advances in understanding diabetes and availability of new drugs and technologies, optimal glycemic management remains a challenge. in treatment. The aim of study was to evaluate metabolic control in the treatment of long-term diabetic patients in an endocrinology service.

METHODS : Non-concurrent cohort that retrospectively evaluated follow-up forms in therapeutic groups of patients with type 1 and type 2 DM undergoing treatment at the outpatient segment of the Hospital das Clínicas at Belo Horizonte/Brazil who had a follow-up time greater than or equal to six months.

RESULTS : 74 patients were followed up, 54 DM2 and 20 DM1, mean age 54 ± 13.37 years, mean duration of DM 16.7 ± 7.2 years, high prevalence of comorbidities and chronic complications of DM. Comparing baseline and final follow-up variable values, Fasting Blood Glucose (mg / dL), Creatinine, Systolic BP (mmHg) and Diastolic BP (mmHg) for DM2 patients decreased significantly, while HDL Cholesterol (mg / dL) for DM1 (Table 2) increased significantly. The cumulative incidences of eye, heart, kidney, nervous system and arterial complications were 30%, 29%, 70%, 63% and 42% respectively in the DM1 and 11%, 25%, 31%, 4% group. and 22% in the DM2 group. Only 4.9% of HbA1c results were explained by the correlation of the variables.

CONCLUSIONS : There were no clinically significant differences in glycemic control variables between beginning and end of follow-up. We observed a higher incidence of chronic complications in the DM1 group than DM2 during follow-up. Despite the multiple variables evaluated, no strong correlations with HbA1c were observed. The results of this analysis prove the complexity in elucidating the determinants of glycemic control and the influence of continuity of care in the treatment of individuals with DM.