The treat-to-target paradigm: A cross-sectional survey of current therapies and achieved metabolic control in 800 type 2 diabetic patients

The aim of this cross-sectional study is to analyse the current treatment schemes as well as the quality of control (metabolic; blood pressure) in a cohort of 800 type 2 diabetic patients recruited in a University Center and not by generalist practionners, in scope with current international recommendations. Insulin therapy was administered, alone or combined with oral antihyperglycaemic drugs, to 48% of subjects. HbA(1)c was 7.7% (6.7-8.7 (median; percentiles 25-75)). Anti-dyslipidaemic drugs were used in 45% of individuals. However, only 27% of the cohort had LDL levels lower than 100 mg/dl while 58% of males and 48% of females attained HDL targets. Systolic and diastolic blood pressure levels were 144 +/- 21 and 81 +/- 12 mmHg (mean +/- SD), despite one or more antihypertensive agent(s) prescribed to 68% of subjects. In conclusion, 79 in a Belgian adult type 2 diabetic population attending a tertiary centre for follow-up, overall metabolic and blood pressure controls remain unsatisfactory according to targets defined by international guidelines. This audit makes a multi-faceted intervention aimed at intensifying current therapies all the more necessary.