Clinical and demographic characteristics, management of patients with type 2 diabetes mellitus and vascular complications: analysis of the Ukrainian cohort of the DISCOVER Global Registry

Main Article Content

O. M. Parkhomenko
B. M. Mankovsky
M. V. Vlasenko
L. K. Sokolova
Ya. M. Lutay
O. I. Irkin
O. L. Feiziieva
S. O. Kostetska
L. S. Onachenko
N. V. Vilchynska
S. V. Shkarivska
N. I. Kravchuk
D. I. Chub
N. O. Pertseva
K. Yu. Malyar
V. G. Neporada
Ya. A. Saienko
O. V. Dovhan

Abstract

The aim – to describe baseline data of the Ukraine cohort of DISCOVER Global Registry (DGR) with real-world insights on current treatment practices, complications, and associated clinical outcomes in people with type 2 diabetes mellitus (T2DM).
Materials and methods. This healthcare provider-led prospective registry involves non‑interventional data collection from adults (aged ≥ 18 years) with T2DM receiving standard medical care as part of routine clinical practice per their treating physician’s discretion.
Results and discussion. The initial data of 353 people with T2DM, who were included in the Ukrainian cohort of the DGR Register, were analyzed. The mean (±standard deviation) age of the study population was 58.85±10.02 years with female predominance (64 % [n=226]). The mean T2DM duration was 10.27±12.15 years with a mean glycated hemoglobin (HbA1c) level of 8.62±1.89 %. Only one-fifth (20.5 %, n=59) of the patients had glycemic control (HbA1c < 7.0 %). Among those with any complication, 73.8 % had microvascular and 79.3 % had cardiovascular complications. Retinopathy and heart failure were the most common microvascular and cardiovascular complications, respectively. Overall, 88 % of the patients were taking any antidiabetic therapy; of these, 27.3 % received insulin (monotherapy: n=28; combination therapy: n=57). As oral antidiabetic drugs (OAD), 32.2 % and 12.9 % received metformin and sulphonylurea monotherapies, respectively; minor proportions received newer OAD monotherapy (sodium-glucose co-transporter-2 inhibitors [4.8 %] and dipeptidyl peptidase-4 inhibitor [1 %]).
Conclusions. Baseline data from the Ukraine cohort of DGR reveals poor glycemic control, with a higher mean HbA1c and proportion of patients with micro- and cardiovascular complications than that of the global cohort. The landscape of therapeutic agents displayed marked diversities in the management strategies. Robust real-world data from the DGR can help understand the gaps in care of T2DM patients and lights the need of the formulation of region-specific holistic therapeutic strategies to optimize glycemic control and improving clinical patients’ outcomes.

Article Details

Keywords:

glycemic control, hypoglycemic drugs, registers, type 2 diabetes mellitus

References

Alifanov I.S., Sakovych V.N., Alifanova T.O. et al. Disability due to ocular complications of diabetes mellitus in Ukraine // J. Ophthalmol. (Ukraine).– 2019.– Vol. 6.– P. 34–38. Available from http://www.ozhurnal.com/en/archive/2019/6/6-fulltext. doi: 10.31288/oftalmolzh201963438.

American Diabetes Association. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2020 // Diabetes Care.– 2020.– Vol. 43.– P. S193‑S202.

Available from https://care.diabetesjournals.org/content/43/Supplement_1/S193. doi: 10.2337/dc20-S015.

Aschner P., Gagliardino J.J., Ilkova H. et al. Persistent poor glycaemic control in individuals with type 2 diabetes in developing countries: 12 years of real-world evidence of the International Diabetes Management Practices Study (IDMPS) // Diabetologia.– 2020.– Vol. 63, No 4.– P. 711–721. Available from https://link.springer.com/article/10.1007/s00125-019-05078-3. doi: 10.1007/s00125-019-05078-3.

Das S.R., Everett B.M., Birtcher K.K. et al. 2020 Expert consensus decision pathway on novel therapies for cardiovascular risk reduction in patients with type 2 diabetes: A report of the American College of Cardiology Solution Set Oversight Committee // J. Am. Col. Cardiol.– 2020.– Vol. 76, No. 9.– P. 1117–1145. Available from https://pubmed.ncbi.nlm.nih.gov/32771263/. doi: 10.1016/j.jacc.2020.05.037.

Demchuk M., Pokotylo O., Denys A. et al. Nationwide trends in antidiabetic drugs (type-2) utilization, Ukraine, 2014–2016 // Int. J. Green Pharm.– 2018.– Vol. 12, No 1.– P. S181–187. Available from https://www.greenpharmacy.info/index.php/ijgp/article/view/1617. doi: 10.22377/ijgp.v12i01.1617.

Doroshenko O., Khan O., Fraser-Hurt N. et al. Type-2 Diabetes Care in Ukraine: Breakpoints and Implications for Action. The World Bank.– 2019. Available from https://openknowledge.worldbank.org/bitstream/handle/10986/31157/133695.pdf?sequence=1&isAllowed=y].

Garber A.J., Abrahamson M.J., Barzilay J.I. et al. AACE/ACE comprehensive diabetes management algorithm 2015 // Endocr. Pract.– 2015.– Vol. 21.– P. 438–447. Available from https://pubmed.ncbi.nlm.nih.gov/25877012/. doi: 10.4158/EP15693.CS.

Iakovlieva L., Tkachova O., Bezditko N. et al. Analysis of oral hypoglycemic drugs consumption in Ukraine in 2015 // Value in Health.– 2017.– Vol. 20, No 9.– P. A486. Available from https://www.valueinhealthjournal.com/article/S1098-3015(17)30829-X/pdf. doi: 10.1016/j.jval.2017.08.

IDF diabetes atlas Ninth edition. – 2019. Available from [https://www.diabetesatlas.org/en/]

Khalangot M., Tronko M. Primary care diabetes in Ukraine // Prim. Care Diabetes.– 2007.– Vol. 1, No. 4.– P. 203–205. Available from https://pubmed.ncbi.nlm.nih.gov/18632047/. doi: 10.1016/j.pcd.2007.10.041.

Khalangot M., Tronko M., Kravchenko V. et al. Body mass index and the risk of total and cardiovascular mortality among patients with type 2 diabetes: a large prospective study in Ukraine // Heart.– 2009.– Vol. 95, No 6.– P. 454–460. Available from https://pubmed.ncbi.nlm.nih.gov/18697804/. doi: 10.1136/hrt.2008.150524.

Kosiborod M., Cooper A., Fenici P. et al. The DISCOVER Global Registry: a long term, large scale patient registry of routine care for people with type 2 diabetes // Diabetologia.– 2020.– Vol. 63, No. 1,– P. S140–S141. New York, United States: Springer. Presented online at the 56th Annual Meeting of the European Association for the Study of Diabetes, 21–25 September 2020 Available from [https://lib.lut.edu.cn/asset/detail/0/203981457575].

Kosiborod M., Gomes M.B., Nicolucci A. et al. Vascular complications in patients with type 2 diabetes: prevalence and associated factors in 38 countries (the DISCOVER study program) // Cardiovas. diabetol.– 2018.– Vol. 17, No. 1.– P. 150. Available from https://cardiab.biomedcentral.com/articles/10.1186/s12933-018-0787-8. doi: 10.1186/s12933-018-0787-8.

Mach F., Baigent C., Catapano A.L. et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) // Eur. Heart. J.– 2020.– Vol. 41, No 1.– P. 111–188. Available from https://pubmed.ncbi.nlm.nih.gov/31504418/. doi: 10.1093/eurheartj/ehz455.

Martinez R., Lloyd-Sherlock P., Soliz P. et al. Trends in premature avertable mortality from non-communicable diseases for 195 countries and territories, 1990–2017: a population-based study // Lancet Glob. Health.– 2020.– Vol. 8, No 4.– P. e511–523. Available from https://www.sciencedirect.com/science/article/pii/S2214109X20300358. doi: 10.1016/S2214-109X(20)30035-8.

Olga Grintsova. Access and use of medicines in Ukraine. In: global pharmaceutical policy.– Singapore. Palgrave Macmillan, 2020.– 247–260 p. Available from https://pure.hud.ac.uk/en/publications/access-and-use-of-medicines-in-ukraine. doi: 10.1007/978-981-15-2724-1_9.

Rabizadeh S., Nakhjavani M., Esteghamati A. Cardiovas­­cular and renal benefits of SGLT2 inhibitors: a narrative review // Int. J. Endocrinol. Metab.– 2019.– Vol. 17, No 2.– P. e84353. Available from https://pubmed.ncbi.nlm.nih.gov/31372172/. doi: 10.5812/ijem.84353.

Saeedi P., Petersohn I., Salpea P. et al. Global and regional diabetes prevalence estimates for 2019 and rojections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition // Diabetes. es.

Clin. Pract.– 2019.– Vol. 157.– P. 107843. Available from https://pubmed.ncbi.nlm.nih.gov/31518657/. doi: 10.1016/j.diabres.2019.107843.

Stuart R.M., Khan O., Abeysuriya R. et al. Diabetes care cascade in Ukraine: an analysis of breakpoints and opportunities for improved diabetes outcomes // BMC Health Serv. Res.– 2020.– Vol. 20, No. 1.– P. 409. Available from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05261-y doi: 10.1186/s12913-020-05261-y.

Yang J.J., Yu D., Wen W. et al. Association of diabetes with all-cause and cause-specific mortality in Asia: a pooled analysis of more than 1 million participants // JAMA Network Open.– 2019.– Vol. 2, No 4.– P. e192696. Available from https://pubmed.ncbi.nlm.nih.gov/31002328/. doi: 10.1001/jamanetworkopen.2019.2696.

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