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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
  • St Helens and Knowsley Hospitals NHS Trust

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

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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
Pages (from-to)257-265
Number of pages9
JournalClinical Medicine, Journal of the Royal College of Physicians of London
Volume22
Issue number3
Early online date20 Apr 2022
DOIs
Publication statusE-pub ahead of print - 20 Apr 2022

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

Keywords

  • individualisation
  • glycated haemoglobin
  • patient factors
  • type 2 diabetes
  • Diabetes Mellitus, Type 2/drug therapy
  • Humans
  • Adult
  • Blood Glucose
  • Glycated Hemoglobin
  • Hypoglycemic Agents/therapeutic use
  • Hypoglycemia

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