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Glycaemic control in the diabetes and lifestyle cohort twente: a cross-sectional assessment of lifestyle and pharmacological management on Hba1c target achievement
The majority of patients with type 2 diabetes do not reach target levels of glycated haemoglobin (HbA1c < 7%). We investigated the prevalence of HbA1câtarget achievement and opportunities afforded by lifestyle and pharmacological treatment to increase target achievement. We performed crossâsectional analyses of baseline data from the Diabetes and Lifestyle Cohort Twenteâ1 (DIALECTâ1). Patients were divided according to (1) HbA1c <53 and â„53 mmol/mol (<7%) and (2) nonâinsulin treatment and tertiles of daily insulin use. We found that 161 (36%) patients achieved the target HbA1c level. Patients with HbA1c â„53 mmol/mol had a longer duration of diabetes (13 [8â20] vs 9 [4â14] years; P < .001) and more frequently were insulinâusers (76% vs 41%, P < .001). Patients in the highest tertile of insulin use had a higher body mass index than those in the lowest tertile (35.8 ± 5.5 vs 29.8 ± 5.5 kg/m2; P < .001). Achievement of target HbA1c is low in this type 2 diabetes population. High resistance to pharmacological treatment, paralleled with high body mass index, illustrates that increasing insulin sensitivity through lifestyle intervention is the best opportunity to improve HbA1c target achievement in this realâlife population