Staff View: Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study

Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study

Aim Given a lack of data on diabetes care performance in Malaysia, we conducted a cross-sectional study to understand the clinical characteristics, control of cardiometabolic risk factors, and patterns of use of guideline-directed medical therapy (GDMT) among patients with type 2 diabetes (T2D), who...

Full description

Saved in:

Bibliographic Details
Main Authors:	Lim, Lee-Ling, Hussein, Zanariah, Noor, Nurain Md, Abd Raof, Anis S., Mustafa, Norlaila, Long Bidin, Mohamed B., Ghani, Rohana Abdul, Samsuddin, Syahrizan, Yong, Sy-Liang, Foo, Siew-Hui, Raghuram, Kavitha, Suwannasri, Payiarat, Mohamad, Wan W.B., Chiew, Thiam Kian, Chan, Siew Pheng
Format:	Article
Published:	Public Library of Science 2024
Subjects:	R Medicine
Online Access:	http://eprints.um.edu.my/44935/
Tags:	Add Tag No Tags, Be the first to tag this record!

id	my.um.eprints.44935
record_format	eprints
spelling	my.um.eprints.449352024-05-03T07:26:56Z http://eprints.um.edu.my/44935/ Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study Lim, Lee-Ling Hussein, Zanariah Noor, Nurain Md Abd Raof, Anis S. Mustafa, Norlaila Long Bidin, Mohamed B. Ghani, Rohana Abdul Samsuddin, Syahrizan Yong, Sy-Liang Foo, Siew-Hui Raghuram, Kavitha Suwannasri, Payiarat Mohamad, Wan W.B. Chiew, Thiam Kian Chan, Siew Pheng R Medicine Aim Given a lack of data on diabetes care performance in Malaysia, we conducted a cross-sectional study to understand the clinical characteristics, control of cardiometabolic risk factors, and patterns of use of guideline-directed medical therapy (GDMT) among patients with type 2 diabetes (T2D), who were managed at publicly-funded hospitals between December 2021 and June 2022. Methods Patients aged ≥18 years with T2D from eight publicly-funded hospitals in the Greater Kuala Lumpur region, who had ≥2 outpatient visits within the preceding year and irrespective of treatment regimen, were eligible. The primary outcome was ≥2 treatment target attainment (defined as either HbA1c <7.0, blood pressure BP <130/80 mmHg, or low-density lipoprotein cholesterol LDL-C <1.8 mmol/L). The secondary outcomes were the individual treatment target, a combination of all three treatment targets, and patterns of GDMT use. To assess for potential heterogeneity of study findings, all outcomes were stratified according to prespecified baseline characteristics namely 1) history of atherosclerotic cardiovascular disease (ASCVD; yes/no) and 2) clinic type (Diabetes specialist versus General medicine). Results Among 5094 patients (mean±SD age 59.0±13.2 years; T2D duration 14.8±9.2 years; HbA1c 8.2±1.9% (66±21 mmol/mol); BMI 29.6±6.2 kg/m2; 45.6% men), 99% were at high/very high cardiorenal risk. Attainment of ≥2 treatment targets was at 18%, being higher in General medicine than in Diabetes specialist clinics (20.8% versus 17.5%; p = 0.039). The overall statin coverage was 90%. More patients with prior ASCVD attained LDL-C <1.4 mmol/L than those without (13.5% versus 8.4%; p<0.001). Use of sodium-glucose cotransporter-2 (SGLT2) inhibitors (13.2% versus 43.2%), glucagon-like peptide-1 receptor agonists (GLP1-RAs) (1.0% versus 6.2%), and insulin (27.7% versus 58.1%) were lower in General medicine than in Diabetes specialist clinics. Conclusions Among high-risk patients with T2D, treatment target attainment and use of GDMT were suboptimal. © 2024 Lim et al. Public Library of Science 2024 Article PeerReviewed Lim, Lee-Ling and Hussein, Zanariah and Noor, Nurain Md and Abd Raof, Anis S. and Mustafa, Norlaila and Long Bidin, Mohamed B. and Ghani, Rohana Abdul and Samsuddin, Syahrizan and Yong, Sy-Liang and Foo, Siew-Hui and Raghuram, Kavitha and Suwannasri, Payiarat and Mohamad, Wan W.B. and Chiew, Thiam Kian and Chan, Siew Pheng (2024) Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study. PLoS ONE, 19 (1 Janu). ISSN 1932-6203, DOI https://doi.org/10.1371/journal.pone.0296298 <https://doi.org/10.1371/journal.pone.0296298>. 10.1371/journal.pone.0296298
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	R Medicine
spellingShingle	R Medicine Lim, Lee-Ling Hussein, Zanariah Noor, Nurain Md Abd Raof, Anis S. Mustafa, Norlaila Long Bidin, Mohamed B. Ghani, Rohana Abdul Samsuddin, Syahrizan Yong, Sy-Liang Foo, Siew-Hui Raghuram, Kavitha Suwannasri, Payiarat Mohamad, Wan W.B. Chiew, Thiam Kian Chan, Siew Pheng Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study
description	Aim Given a lack of data on diabetes care performance in Malaysia, we conducted a cross-sectional study to understand the clinical characteristics, control of cardiometabolic risk factors, and patterns of use of guideline-directed medical therapy (GDMT) among patients with type 2 diabetes (T2D), who were managed at publicly-funded hospitals between December 2021 and June 2022. Methods Patients aged ≥18 years with T2D from eight publicly-funded hospitals in the Greater Kuala Lumpur region, who had ≥2 outpatient visits within the preceding year and irrespective of treatment regimen, were eligible. The primary outcome was ≥2 treatment target attainment (defined as either HbA1c <7.0, blood pressure BP <130/80 mmHg, or low-density lipoprotein cholesterol LDL-C <1.8 mmol/L). The secondary outcomes were the individual treatment target, a combination of all three treatment targets, and patterns of GDMT use. To assess for potential heterogeneity of study findings, all outcomes were stratified according to prespecified baseline characteristics namely 1) history of atherosclerotic cardiovascular disease (ASCVD; yes/no) and 2) clinic type (Diabetes specialist versus General medicine). Results Among 5094 patients (mean±SD age 59.0±13.2 years; T2D duration 14.8±9.2 years; HbA1c 8.2±1.9% (66±21 mmol/mol); BMI 29.6±6.2 kg/m2; 45.6% men), 99% were at high/very high cardiorenal risk. Attainment of ≥2 treatment targets was at 18%, being higher in General medicine than in Diabetes specialist clinics (20.8% versus 17.5%; p = 0.039). The overall statin coverage was 90%. More patients with prior ASCVD attained LDL-C <1.4 mmol/L than those without (13.5% versus 8.4%; p<0.001). Use of sodium-glucose cotransporter-2 (SGLT2) inhibitors (13.2% versus 43.2%), glucagon-like peptide-1 receptor agonists (GLP1-RAs) (1.0% versus 6.2%), and insulin (27.7% versus 58.1%) were lower in General medicine than in Diabetes specialist clinics. Conclusions Among high-risk patients with T2D, treatment target attainment and use of GDMT were suboptimal. © 2024 Lim et al.
format	Article
author	Lim, Lee-Ling Hussein, Zanariah Noor, Nurain Md Abd Raof, Anis S. Mustafa, Norlaila Long Bidin, Mohamed B. Ghani, Rohana Abdul Samsuddin, Syahrizan Yong, Sy-Liang Foo, Siew-Hui Raghuram, Kavitha Suwannasri, Payiarat Mohamad, Wan W.B. Chiew, Thiam Kian Chan, Siew Pheng
author_facet	Lim, Lee-Ling Hussein, Zanariah Noor, Nurain Md Abd Raof, Anis S. Mustafa, Norlaila Long Bidin, Mohamed B. Ghani, Rohana Abdul Samsuddin, Syahrizan Yong, Sy-Liang Foo, Siew-Hui Raghuram, Kavitha Suwannasri, Payiarat Mohamad, Wan W.B. Chiew, Thiam Kian Chan, Siew Pheng
author_sort	Lim, Lee-Ling
title	Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study
title_short	Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study
title_full	Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study
title_fullStr	Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study
title_full_unstemmed	Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study
title_sort	real-world evaluation of care for type 2 diabetes in malaysia: a cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (target-t2d) study
publisher	Public Library of Science
publishDate	2024
url	http://eprints.um.edu.my/44935/
_version_	1800082909643669504
score	13.211869

Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study

Similar Items