@article{3106086,
    title = "A Greek registry of current type 2 diabetes management, aiming to determine core clinical approaches, patterns and strategies",
    author = "Liatis, S. and Iraklianou, S. and Kazakos, K. and Mastorakos, G. and Milios, K. and Mouslech, Z. and Noutsou, M. and Pagkalos, E. and Sampanis, C. and Zoi, A. and Olga, A.-K. and Eleni, A. and Iakovos, A. and Sofoklis, B. and Alexandra, B. and Christos, B. and Stavros, B. and Dimitrios, B. and Georgios, C. and Alexandra, C. and Triantafyllos, D. and George, D. and Eftihia, D. and Petros, D. and John, D. and Triada, E. and Maria, G. and Nikolaos, G. and Pinelopi, G. and Ioannis, I. and Evridiki, K. and Kostas, K. and Panagiotis, K. and Kalliopi, K. and Maria, K. and Leonidas, L. and Konstantinos, M. and Christos, M. and Georgios, M. and Andreas, M. and Ilias, M. and Asimina, M. and Stefanos, P. and Dimitrios, P. and Georgios, P. and Evangelos, P. and Ioannis, P. and Evangelos, R. and Maria, R. and Alexandra, R. and Christos, S. and Aimilios, S. and Dimitrios, S. and El Hasban, T. and Nikolaos, T. and Anastasia, T. and Apostolos, T. and Iraklis, T. and Apostolos, T. and Panagiotis, T. and Agathoklis, T. and Stefanos, T. and Glykeria, T. and Panagiotis, V. and Charalampos, V. and Anestis, V. and Andromachi, V. and Apostolos, X.",
    journal = "BMC Endocrine Disorders",
    year = "2019",
    volume = "19",
    number = "1",
    publisher = "BioMed Central Ltd.",
    issn = "1472-6823",
    doi = "10.1186/s12902-019-0364-5",
    keywords = "DNA formamidopyrimidine glycosylase;  hemoglobin A1c;  insulin;  oral antidiabetic agent;  antidiabetic agent;  biological marker;  glycosylated hemoglobin;  hemoglobin A1c protein, human, adult;  age distribution;  aged;  Article;  carotid artery disease;  clinical decision making;  cross-sectional study;  diabetic foot;  diabetic nephropathy;  diabetic neuropathy;  diabetic retinopathy;  dietary compliance;  disease duration;  female;  geographic distribution;  glycemic control;  Greece;  human;  insulin treatment;  lifestyle modification;  major clinical study;  male;  non insulin dependent diabetes mellitus;  observational study;  outpatient department;  peripheral occlusive artery disease;  practice guideline;  register;  risk reduction;  treatment failure;  university hospital;  analysis;  clinical practice;  clinical trial;  disease management;  follow up;  glucose blood level;  middle aged;  multicenter study;  non insulin dependent diabetes mellitus;  patient selection;  prognosis;  standards;  statistics and numerical data, Aged;  Biomarkers;  Blood Glucose;  Cross-Sectional Studies;  Diabetes Mellitus, Type 2;  Disease Management;  Female;  Follow-Up Studies;  Glycated Hemoglobin A;  Greece;  Humans;  Hypoglycemic Agents;  Male;  Middle Aged;  Patient Selection;  Practice Guidelines as Topic;  Practice Patterns, Physicians';  Prognosis;  Registries",
    abstract = "Background: To analyze data in terms of the glycaemic control and therapeutic regimens used for Type-2 Diabetes Mellitus (T2DM) management in Greece, identify factors that influence clinical decisions and determine the level of compliance of T2DM management with the latest international and local guidelines. Methods: 'AGREEMENT' was a national-multicenter, non-interventional, cross-sectional disease registry. A total of 1191 adult T2DM patients were enrolled consecutively from 59 sites of the National Health System (NHS) or University Hospitals, representing the majority of Diabetes centers or Diabetes outpatient clinics in Greece with a broad geographic distribution. Patients were stratified by gender and analysis was done according to 3 treatment strategies: A (lifestyle changes or use of one oral antidiabetic agent), B (up to 3 antidiabetic agents including injectables but not insulin) and C (any regimens with insulin). Results: Mean (±SD) HbA1c % of the total population was 7.1 (±1.2) while mean (±SD) FPG (mg/dl) was measured at 136 (±42). The proportion of patients who achieved HbA1c < 7% was 53% and ranged from 74.2% for group A, to 60.6% for group B and 35.5% for group C. Median age of the studied population was 65.0 year old (Interquartile Range-IQR 14.0) with an equal distribution of genders between groups. Patients on insulin therapy (treatment strategy C) were older (median age: 67 years vs 63 or 65 for A and B, respectively) with longer diabetes duration (mean duration: 15.3 years vs 5.2 and 10.1 for A and B, respectively). Patients who received insulin presented poor compliance. There was a consensus for a series of decision criteria and factors that potentially influence clinical decisions, used by physicians for selection of the therapeutic strategy among the three groups. Compliance with international and Greek guidelines received a high score among groups A, B and C. No significant differences were presented as per sites' geographic areas, NHS or University centers and physicians' specialty (endocrinologists, diabetologists and internists). Conclusions: The presented findings suggest the need for improvement of the glycaemic control rate, especially among insulin treated patients as this group seems to achieve low glycaemic control, by setting appropriate HbA1c targets along with timely and individualised intensification of treatment as well as post-therapy evaluation of the compliance with the proposed treatment. © 2019 The Author(s)."
}