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Factors associated with a rapid normalization of HbA1c in newly diagnosed type 2 diabetes patients seen in a specialist setting

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Abstract

The time to achieve good metabolic control after diagnosis is essential for type 2 diabetes patients because it can influence long-term prognosis. This study aimed to elucidate the predictive role of several clinical and organization factors in normalizing metabolism within 6 months. A multi-centered, retrospective, observational study on 960 patients, with diabetes duration of 12 months or less, consecutively seen in 123 Italian clinics, was undertaken. Information about clinic’s organization, along with data abstracted from medical records at enrollment (first visit) and after 6 months (follow-up visit), was collected. At 6 months, HbA1c dropped by −3.1 ± 2.2 points in those who achieved HbA1c <7 % (responders), whereas in non-responders (HbA1c ≥7 %), the mean reduction was −1.8 ± 1.9. The intervention markedly reduced lipids, blood pressure, BMI, and waist circumference, especially in responders. The presence of a diabetes team correlated with a likelihood of HbA1c normalization (OR 1.94, 1.17–3.22). By contrast, indicators of advanced disease such as previous retinopathy (0.53, 0.29–0.98), use of secretagogues (0.40, 0.25–0.64), high levels of HbA1c at first visit and related insulin use emerged as adverse factors. Early detection of diabetes, along with human resources and organization, was found to play a crucial role in rapidly attaining good metabolic control.

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Acknowledgments

The SUBITO! (Safe_Uniform_Behavioral and drug_Intensive_Treatment for_Optimal_ control) project by AMD (Italian Association of Clinical Diabetologists) has been entirely funded by Fondazione AMD, Viale delle Milizie, 96 Rome Italy, a non-profit institution for research in metabolic disease and diabetes. The Writing Committee would like to thank the individual investigators who made this study so valuable by their participation. It is also indebted to Dr Piero Guida, who provided statistical support in the analysis of the study results.

Author information

Authors and Affiliations

  1. Metabolism and Diabetes Unit, ASL, Turin 5, Italy

    C. B. Giorda & L. Marafetti

  2. Metabolism and Diabetes Unit, Oristano, Italy

    M. F. Mulas

  3. Montecchio Hospital, Montecchio Emilia, Italy

    V. Manicardi

  4. Metabolism and Diabetes Unit, Pertini Hospital, Rome, Italy

    C. Suraci

  5. Cardiology Unit, Emergency and Organ Transplantation Department, University of Bari, Bari, Italy

    P. Guida

  6. Chaira Medica Association, Chieri, Italy

    E. Nada

  7. University of Naples, Naples, Italy

    S. Gentile

Authors
  1. C. B. Giorda
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  2. M. F. Mulas
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  3. V. Manicardi
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  4. C. Suraci
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  5. P. Guida
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  6. L. Marafetti
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  7. E. Nada
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  8. S. Gentile
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Corresponding author

Correspondence to C. B. Giorda.

Additional information

Communicated by Renato Lauro.

The study was conducted on behalf of the SUBITO! AUDIT Study Group. For the complete details of SUBITO! AUDIT Study Group, see “Appendix”.

Appendix

Appendix

Acquati Silvia, Forlì; Aglialoro Alberto, Genova; Alfidi Pasquale, Avezzano; Angiulli Bruno, Napoli; Anichini Roberto, Pistoia; Antonelli Antonio, Agnone; Arlotta Vincenzo, Patti; Azzarone Vincenza, Monte Sant’Angelo; Blatto Alberto, Pianezza; Botta Amodio, Avellino; Buschini Marco, Borgomanero; Busciantella Ricci, Camerino; Calzolari Giovanna, Mirandola; Capobianco Giuseppe, Giugliano in Campania; Cartechini Maria Giulia, Camerino; Chierici Giuseppina, Reggio Emilia; Ciaravella Adolfo, S. Lazzaro; Clementi Lina, San Benedetto del Tronto; Cocca Angelo, Cerreto Sannita; Comoglio Marco, Moncalieri; Conti Antonio, Milano; Cossu Marina, Oristano; Costa Laia Laura, Ivrea; Cotti Luisella, Fano; De Ciocchis Anita, Subiaco; De Marco Federica, Castel di Sangro; De Monte Ariella, Trieste; De Simone Giuseppina, San Giorgio a Cremano; Del Buono Andrea, Sessaurunca-Cellole; Derai Raffaella, San Gavino; Di Benedetto Antonino, Messina; Di Berardino, Atri; Di Palo Mariarosaria, Napoli; Di Vieste Giacoma, Messina; Di Vincenzo Simonetta, Campobasso; Diodati Maria Bruna, Sulmona; Disoteo Olga Eugenia, Milano; Finardi Lorenzo, Montecchio; Forlani Gabriele, Bologna; Fornengo Riccardo, Chivasso; Forte Elisa, Iavoli; Fraticelli Emanuele, Bra, Fusetti Patrizio, Legnano; Gagliardi Roberto, Roma; Gamba Concetta, Garofalo Arcangela, Vittoria; Garrapa Gabriella, Fano; Giovannini Celestino, Reggio Calabria; Grosso Juliette, Castel di sangro; Guarino Giuseppina, Napoli; Iannarelli Rossella, L’Aquila; La Penna Giuliana, Pescara; Lacasella Raffaele, Canosa di Puglia; Laffi Gilberto, Bologna; Lai Alessio, Cagliari; Laudato Mario, Maddaloni; Leotta Sergio, Roma; Lesina Annelisa, Carmagnola; Lo Presti Antonino, Marsala; Macerola Barbara, Sulmona; Madau Gianfranco, Oristano; Magro Giampaolo, Cuneo; Malci Francesco, Subiaco; Manfrini Silvana, Senigallia; Manicardi Ivana, Montecchio; Manti Roberta, Moncalieri; Marelli Giuseppe, Vimercate; Massafra Cinzia, Milano; Melandri Piero, Lugo; Meloncelli Illidio, San Benedetto del Tronto; Michelini Massimo, Montecchio; Modugno Monica, Gioia del Colle; Monesi Marcello, Ferrara; Nogara Andrea, Chioggia; Origlia Carla, Chieri; Paciotti Vincenzo, Avezzano; Pagano Adalberto, Albano Laziale; Parini Stefano, Budrio; Pascal Giancarlo, Mantova; Pauletto Natalino, Verona; Pellicano Francesca, Ravenna; Perrone Giovanni, Reggio Calabria; Pisanu Paola, Muravera; Pizzi Gianluigi, Milano; Pocciati Sergio, Foligno; Ponziani Paola, Arenzano; Ponziani Maria Chantal, Novara; Portolan Ferderica, Cles; Pozzuoli Giuseppe, Caserta; Pucci Achiropita, Cosenza; Ramunni Maria Isabella, Foggia; Rapisardi Riccardo, Catania; Ricciardi Grazia Pia, Aprilia; Richini Donata, Esine; Ridola Giovanni, Palermo; Romeo Francesco, Carmagnola; Saglietti Giuseppe, Omegna; Saitta Giovanni, Messina; Santantonio Graziano, Civitavecchia; Santilli Enrico, Velletri; Scarpitta Antonietta Maria, Marsala; Sciangula Luigi, Mariano Comense; Serra Rosalia, Lecce; Sforza Alessandra, Bologna; Sica Vincenzo, San Gavino Monreale; Sposito Silvio, Velletri; Strollo Felice, Roma; Tondini Sergio, Castel del Piano; Trabacca Maria Stella, Genova; Vaccaro Maria, Palermo; Velussi Mario, Aurisina; Venezia Angelo, Matera; Verdecchia Bruno, Avezzano; Vetrini Giulietta, Val Vibrata; Zavaroni Donatella, Piacenza; Zavaroni Ivana, Parma; Zocca Alfredo, Milano.

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Giorda, C.B., Mulas, M.F., Manicardi, V. et al. Factors associated with a rapid normalization of HbA1c in newly diagnosed type 2 diabetes patients seen in a specialist setting. Acta Diabetol 50, 81–87 (2013). https://doi.org/10.1007/s00592-012-0431-0

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  • DOI: https://doi.org/10.1007/s00592-012-0431-0

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