To clarify the actual usage of oral hypoglycemic agents (OHA) and insulin preparations (INS) and their effectiveness on glycemic control in patients with type 2 diabetes mellitus in Japan, we analyzed clinical data collected from 34 institutes using CoDiC
®, an electronic system for diabetes data collection and management. In 15,553 type 2 diabetic patients registered with CoDiC
® from January to July 2003, 36% were treated with OHA monotherapy, 33% with OHA combination therapy, 11% with INS plus OHA combination therapy, and 20% with INS monotherapy. A cross-sectional survey of 14,099 patients whose HbA
1C data had been input CoDiC
® showed that glycemic control was excellent or good in 29%, fair in 49%, and poor in 22%. Among those undergoing OHA monotherapy control was the poorest in patients treated with sulfonylureas. It was poorer in patients treated with OHA combination therapy than in patients undergoing OHA monotherapy. Patients undergoing INS plus OHA combination therapy had the poorest glycemic control. Glycemic control was poor in 32% of those undergoing INS monotherapy. In a clinical setting, obtaining ideal glycemic control in many type 2 diabetic patients is therefore difficult with currently available pharmaceutical agents.
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