The individualisation of glycaemic targets in response to patient characteristics in type 2 diabetes: a scoping review

Sam Westall, Ram Prakash Narayanan, SIMON WATMOUGH, GREG IRVING, Niall Furlong, Sid McNulty, Sumudu Bujawansa, KEVIN HARDY

Research output: Contribution to journalArticle (journal)peer-review

Abstract

Background
Evidence and guidelines increasingly support an individualised approach to care of people with type 2 diabetes and individualisation of glycaemic targets in response to patient factors.

Methods
We undertook a scoping review of the literature for evidence of factors impacting upon glycated haemoglobin target individualisation in adults with type 2 diabetes. Data were analysed thematically with themes inductively derived from article review.

Findings
Evidence suggests that presence of cardiovascular disease, hypoglycaemia unawareness, severe hypoglycaemia, limited life expectancy, advanced age, long diabetes duration, frailty, cognitive impairment, disability, extensive comorbidity, diabetes distress and patient preference should inform the setting of glycaemic targets.

Conclusions
The management of people with diabetes is complex. In clinical practice, many patients will have a variety of factors that should be considered when personalising their care. Approaches to personalised care and glycaemic treatment targets should be undertaken as part of a shared decision-making process between physician and patient. Use of electronic records
might enable greater efficiency and more widespread use of personalised care plans in diabetes.
Original languageEnglish
JournalClinical Medicine
Early online date20 Apr 2022
DOIs
Publication statusE-pub ahead of print - 20 Apr 2022

Keywords

  • individualisation
  • glycated haemoglobin
  • patient factors
  • type 2 diabetes

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