Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study
Aim. To understand glucose lowering therapeutic strategies of French general practitioners (GPs) in the management of type 2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD). Methods. A multicenter cross-sectional study was conducted from March to June 2011 among a sample of Frenc...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2013/640632 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850159321661308928 |
|---|---|
| author | N. Grandfils B. Detournay C. Attali D. Joly D. Simon B. Vergès M. Toussi Y. Briand O. Delaitre |
| author_facet | N. Grandfils B. Detournay C. Attali D. Joly D. Simon B. Vergès M. Toussi Y. Briand O. Delaitre |
| author_sort | N. Grandfils |
| collection | DOAJ |
| description | Aim. To understand glucose lowering therapeutic strategies of French general practitioners (GPs) in the management of type 2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD). Methods. A multicenter cross-sectional study was conducted from March to June 2011 among a sample of French GPs who contribute to the IMS Lifelink Disease Analyzer database. Eligible patients were those with T2DM and moderate-to-severe CKD who visited their GPs at least once during the study period. Data were collected through electronic medical records and an additional questionnaire. Results. 116 GPs included 297 patients: 86 with stage 3a (Group 1, GFR = 45–60 mL/min/1.73 m2) and 211 with stages 3b, 4, or 5 (Group 2, GFR < 45 mL/min/1.73 m2). Patients’ mean age was approximately 75 years. Insulin was used in 19% of patients, and was predominant in those with severe CKD. More than two-thirds of patients were treated with glucose lowering agents which were either contraindicated or not recommended for CKD. Conclusion Physicians most commonly considered the severity of diabetes and not CKD in their therapeutic decision making, exposing patients to potential iatrogenic risks. The recent patient oriented approach and individualization of glycemic objectives according to patient profile rather than standard HbA1c would improve this situation. |
| format | Article |
| id | doaj-art-b1a1f4ae6ace4d5f8cb1a16358bf3a74 |
| institution | OA Journals |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-b1a1f4ae6ace4d5f8cb1a16358bf3a742025-08-20T02:23:35ZengWileyInternational Journal of Endocrinology1687-83371687-83452013-01-01201310.1155/2013/640632640632Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional StudyN. Grandfils0B. Detournay1C. Attali2D. Joly3D. Simon4B. Vergès5M. Toussi6Y. Briand7O. Delaitre8IMS Health France, 5-7 Place de la Pyramide, 92088 Paris La Défense, FranceCemka-Eval, 43 Boulevard du Maréchal Joffre, 92340 Bourg-la-Reine, FranceMedical office, 4 Rue de L’Ile de France, 91860 Epinay sous Senart, FranceNephrology Department, Hôpital Necker-Enfants Malades, 149 Rue de Sèvres, 75015 Paris, FranceDiabetes Department, Hôpital de la Pitié-Salpétrière, 47 Boulevard de l’Hôpital, 75013 Paris, FranceEndocrinology Department, Hôpital du Bocage, 1 Boulevard Jeanne d'Arc, 21079 Dijon, FranceIMS Health France, 5-7 Place de la Pyramide, 92088 Paris La Défense, FranceBoehringer-Ingelheim France, 14 Rue Jean Antoine de Baïf, 75013 Paris, FranceBoehringer-Ingelheim France, 14 Rue Jean Antoine de Baïf, 75013 Paris, FranceAim. To understand glucose lowering therapeutic strategies of French general practitioners (GPs) in the management of type 2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD). Methods. A multicenter cross-sectional study was conducted from March to June 2011 among a sample of French GPs who contribute to the IMS Lifelink Disease Analyzer database. Eligible patients were those with T2DM and moderate-to-severe CKD who visited their GPs at least once during the study period. Data were collected through electronic medical records and an additional questionnaire. Results. 116 GPs included 297 patients: 86 with stage 3a (Group 1, GFR = 45–60 mL/min/1.73 m2) and 211 with stages 3b, 4, or 5 (Group 2, GFR < 45 mL/min/1.73 m2). Patients’ mean age was approximately 75 years. Insulin was used in 19% of patients, and was predominant in those with severe CKD. More than two-thirds of patients were treated with glucose lowering agents which were either contraindicated or not recommended for CKD. Conclusion Physicians most commonly considered the severity of diabetes and not CKD in their therapeutic decision making, exposing patients to potential iatrogenic risks. The recent patient oriented approach and individualization of glycemic objectives according to patient profile rather than standard HbA1c would improve this situation.http://dx.doi.org/10.1155/2013/640632 |
| spellingShingle | N. Grandfils B. Detournay C. Attali D. Joly D. Simon B. Vergès M. Toussi Y. Briand O. Delaitre Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study International Journal of Endocrinology |
| title | Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study |
| title_full | Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study |
| title_fullStr | Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study |
| title_full_unstemmed | Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study |
| title_short | Glucose Lowering Therapeutic Strategies for Type 2 Diabetic Patients with Chronic Kidney Disease in Primary Care Setting in France: A Cross-Sectional Study |
| title_sort | glucose lowering therapeutic strategies for type 2 diabetic patients with chronic kidney disease in primary care setting in france a cross sectional study |
| url | http://dx.doi.org/10.1155/2013/640632 |
| work_keys_str_mv | AT ngrandfils glucoseloweringtherapeuticstrategiesfortype2diabeticpatientswithchronickidneydiseaseinprimarycaresettinginfranceacrosssectionalstudy AT bdetournay glucoseloweringtherapeuticstrategiesfortype2diabeticpatientswithchronickidneydiseaseinprimarycaresettinginfranceacrosssectionalstudy AT cattali glucoseloweringtherapeuticstrategiesfortype2diabeticpatientswithchronickidneydiseaseinprimarycaresettinginfranceacrosssectionalstudy AT djoly glucoseloweringtherapeuticstrategiesfortype2diabeticpatientswithchronickidneydiseaseinprimarycaresettinginfranceacrosssectionalstudy AT dsimon glucoseloweringtherapeuticstrategiesfortype2diabeticpatientswithchronickidneydiseaseinprimarycaresettinginfranceacrosssectionalstudy AT bverges glucoseloweringtherapeuticstrategiesfortype2diabeticpatientswithchronickidneydiseaseinprimarycaresettinginfranceacrosssectionalstudy AT mtoussi glucoseloweringtherapeuticstrategiesfortype2diabeticpatientswithchronickidneydiseaseinprimarycaresettinginfranceacrosssectionalstudy AT ybriand glucoseloweringtherapeuticstrategiesfortype2diabeticpatientswithchronickidneydiseaseinprimarycaresettinginfranceacrosssectionalstudy AT odelaitre glucoseloweringtherapeuticstrategiesfortype2diabeticpatientswithchronickidneydiseaseinprimarycaresettinginfranceacrosssectionalstudy |