Background: The American Diabetes Association (ADA) has published several diabetes treatment algorithms, but\r\nnone have been tested in real-life settings. The aim of this study is to analyze the feasibility of achieving and/or\r\nmaintaining HbA1c levels <7.0% using current diabetes treatment guidelines and the resources available in the\r\npublic health care system of Brazil.\r\nMethods: A one-year, single-arm interventional study was conducted with type 2 diabetes patients in a primary\r\ncare unit. Intervention consisted of intensification of lifestyle changes and sequential prescription of drugs based on\r\nADA guidelines using the medications available through the publicly funded Unified Health System (Sistema �šnico\r\nde Sa�ºde, SUS).\r\nResults: Ninety patients (age: 62.7�±10.4 years; diabetes duration: 8.2�±9.1 years) completed the trial. During the\r\nintervention period, increases were observed in number of oral antidiabetic agent (OAD) classes per patient\r\n(1.50�±0.74 vs. 1.67�±0.7; p=0.015), OAD pills per patient (2.64�±1.89 vs. 3.33�±2.23 pills/patient; p <0.001), insulin\r\ndosage (0.20�±0.29 vs.0.50�±0.36 UI/kg/day; p=0.008) and number of patients on insulin (19 [21%] vs. 31 [34%];\r\np<0.01), but no improvement in HbA1c (7.2�±1.6% vs. 7.3�±1.5%; p=0.453) or frequency of patients on target, defined\r\nas HbA1c <7% (53.3% vs. 48.9%; p=0.655). Patients with baseline HbA1c <7% had a small increase in HbA1c during\r\nthe trial (6.3�±0.4 vs. 6.7�±0.9%; p=0.002). No such change was observed in those with baseline HbA1c =7%.\r\nConclusions: In this group of patients with a mean baseline HbA1c of 7.2%, implementation of 2006/2009\r\nADA/EASD guidelines led to achievement of the therapeutic goal of HbA1c <7% in a small proportion of patients
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