[Characterization of patients with type 2 diabetes treated with vildagliptin]. / Caracterização de doentes com diabetes mellitus tipo 2 medicados com vildagliptina.

INTRODUCTION: Diabetes mellitus is a progressive disease and the rapid growth of this global prevalence has been a worldwide concern. About a third of Portuguese population has type 2 diabetes or pre-diabetes. 2 DM is associated with significant morbidity and mortality, although the treatment so far available it is a high percentage of patients who do not achieve the proposed objectives. Vildagliptin is an inhibitor of oral DPP-4, the most studied of this new class. Inhibiting the rapid degradation of incretins, the vildagliptin increases levels of GLP-1, getting this hormone available to modulate the function of a and ß cells. AIMS: This study aims to characterize the first patients with DM2 treated with vildagliptin in the Department of Endocrinology, Diabetes and Metabolism at the Military Hospital. METHODS: Retrospective study with the first 70 patients treated with vildagliptin, between October and December 2008. The information collected was demographic data, disease duration, associated diseases and their medication, metabolic control in the beginning of the disease (values HbA1c) and criteria for use of vildagliptin. RESULTS: Among the patients included in the study, 55, 7% were male, with the average age of 63, 3 years. These patients had a average duration of diabetes of 11, 7 years. Hypertension was the most frequent associated pathology (85.7% of patients), although dyslipidemia and obesity have a high percentage, 80% and 51% respectively. All patients were overweight (BMI =25 Kg/m(2)). More than half of the patients (55,7%) were on monotherapy until the introduction of vildagliptin, having been associated with other oral antidiabetic agents in all patients. CONCLUSIONS: Most of patients showed risk factors, for witch they were medicated. Vildagliptin has been added mostly in patients medicated with metformin. It is suggested that the therapeutic approach in type 2 diabetes is more and more early, effective and secure.

[Quality of care in diabetic outpatient clinics]. / Avaliação da qualidade de cuidados numa consulta de diabetes.

UNLABELLED: Type 2 Diabetes Mellitus affects an increasing number of people throughout the world. Several studies have shown that it is possible to prevent and minimize type 2 diabetes complications, be it treated appropriately over time. This study aimed to determine the quality of care provided to type 2 diabetic patients in our institution, through metabolic control and risk factors evaluation. SUBJECTS AND METHODS: We reviewed the medical records of 776 type 2 diabetic patients, followed at our outpatient clinic between 1998-2004. RESULTS: A total of 588 patients were included in the study, with a mean age of 66,8 ± 27,2 years. 58% were men. HbA1c levels averaged 7,2 ± 1,6. 57% had HbA1c = 7%. 25,3% met the target blood pressure of 130/80 mmHg; 48% met the goal LDL cholesterol level < 100 and 80% < 130 mg/dl. 6,8% of patients met the combined ADA goal for BP, LDL and HbA1c. Concerning therapeutic regimens: 71,5% used oral hypoglycaemic agents (OAD) alone (52,1% of these were using 2 or more agents); 28,5% were treated with insulin (16,2% in combination with OAD). 52,1% of the patients were anti-aggregated with aspirin. CONCLUSIONS: The metabolic control (HbA1c) and LDL values were favourable in our patients sample, comparing to other studies. The percentage of patients treated to the recommended BP of 130/80 mmHg is consistent with the literature. Only 6,8% of patients met the combined ADA goal for BP, LDL and HbA1c. Despite our comparable results to published data, we would like to highlight the difficulty to accomplish international recommendations to metabolic and risk factors control in clinical practice and the necessity of an aggressive approach to diabetes treatment.