dc.contributor.author | Tran, Anh Thi | |
dc.contributor.author | Berg, Tore Julsrud | |
dc.contributor.author | Mdala, Ibrahimu | |
dc.contributor.author | Gjelsvik, Bjørn E. | |
dc.contributor.author | Cooper, John | |
dc.contributor.author | Sandberg, Sverre | |
dc.contributor.author | Claudi, Tor | |
dc.contributor.author | Jenum, Anne Karen | |
dc.date.accessioned | 2021-06-02T12:37:44Z | |
dc.date.available | 2021-06-02T12:37:44Z | |
dc.date.created | 2021-01-21T16:42:43Z | |
dc.date.issued | 2020 | |
dc.Published | Diabetic Medicine. 2020, . | |
dc.identifier.issn | 0742-3071 | |
dc.identifier.uri | https://hdl.handle.net/11250/2757425 | |
dc.description.abstract | Aims
To identify individual and general practitioner (GP) characteristics associated with potential over- and undertreatment of hyperglycaemia in type 2 diabetes and with HbA1c not being measured.
Methods
A cross-sectional study that included 10233 individuals with type 2 diabetes attending 282 GPs. Individuals with an HbA1c measurement during the last 15 months were categorized as potentially overtreated if they were prescribed a sulphonylurea and/or insulin when the HbA1c was less than 53 mmol/mol (7%) when aged over 75 years or less than 48 mmol/mol (6.5%) when aged between 65 and 75 years. Potential undertreatment was defined as age less than 60 years and HbA1c > 64 mmol/mol (8.0%) or HbA1c > 69 mmol/mol (8.5%) and treated with lifestyle modification and/or monotherapy. We used multilevel binary and multinominal logistic regression models to examine associations.
Results
Overall, 4.1% were potentially overtreated, 7.8% were potentially undertreated and 11% did not have HbA1c measured. Characteristics associated with potential overtreatment were as follows: long diabetes duration, prescribed antihypertensive medication, cardiovascular disease and renal failure. Potential undertreatment was associated with male gender, non-western origin and low educational level. Characteristics associated with not having an HbA1c measurement performed were male gender, age < 50 years and cardiovascular diseases. GP specialist status and GPs’ use of a Noklus diabetes application reduced the risk of not having an HbA1c measurement performed.
Conclusion
Potential overtreatment in elderly individuals with type 2 diabetes was relatively low. Nevertheless, appropriate de-intensification or intensification of treatment and regular HbA1c measurement in identified subgroups is warranted. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Wiley | en_US |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/deed.no | * |
dc.title | Factors associated with potential over- and undertreatment of hyperglycaemia and annual measurement of HbA1c in type 2 diabetes in norwegian general practice | en_US |
dc.type | Journal article | en_US |
dc.type | Peer reviewed | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | Copyright 2020 The Authors | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.doi | 10.1111/dme.14500 | |
dc.identifier.cristin | 1876781 | |
dc.source.journal | Diabetic Medicine | en_US |
dc.identifier.citation | Diabetic Medicine. 2020 | en_US |