Basic medication therapy based on target glycated hemoglobin levels in patients with ischemic heart disease and diabetes

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) and ischemic heart disease (IHD) are significant medical conditions. Research indicates that patients with T2DM have a substantially increased risk of developing cardiovascular diseases, necessitating meticulous monitoring and management of both diabetes and associated cardiovascular conditions. Achieving target glycated hemoglobin (HbA1c) levels is crucial for effective T2DM treatment.

Objective: This study investigates the prescribed basic medication therapy in patients with T2DM and IHD based on target HbA1c levels.

Methods: A prospective observational study was conducted at the Republican Specialized Scientific-Practical Medical Center of Cardiology in Uzbekistan from 2022 to 2024, involving 130 patients with T2DM and IHD. Clinical, functional, and instrumental parameters, including left ventricular ejection fraction and other metabolic indicators, were assessed. Data were collected using standardized questionnaires and analyzed using the Statistical Package for Social Sciences. Logistic and linear regression models were used to analyze the efficiency of medication treatment.

Results: Among the cohort, 56.9% achieved an HbA1c level ≤8%, while 43.1% had an HbA1c level ≥8%. Significant differences were observed in age, gender distribution, duration of diabetes, and IHD between the two groups. Medication therapy varied significantly, with higher usage of metformin and insulin in patients with an HbA1c level ≥8%. The linear regression model predicts HbA1c levels based on clinical data and dosages of prescribed medications with a root mean square error of 1.172 and a Spearman correlation coefficient of 0.826. The logistic regression model predicts achievement of target HbA1c levels with a receiver operating characteristic area under the curve value of 0.92.

Conclusion: The study highlights the importance of individualized medication therapy tailored to HbA1c levels to improve clinical outcomes in patients with T2DM and IHD. It also highlights differences in medication effects based on the target HbA1c levels in patients.

Keywords

Diabetes mellitus / Ischemic heart disease / Glycated hemoglobin / Medication therapy

Funding

None.

Conflict of interest

The authors declare they have no competing interests.

References

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