{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:29:16Z","timestamp":1761895756340,"version":"build-2065373602"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,12,16]],"date-time":"2013-12-16T00:00:00Z","timestamp":1387152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to assess associations between patient characteristics, intensification of blood glucose\u2010lowering treatment through oral glucose\u2010lowering therapy and\/or insulin and effective glycaemic control in type 2 diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>11\u2009140 patients from the Action in Diabetes and Vascular disease: preterAx and diamicroN\u2010MR Controlled Evaluation (<jats:styled-content style=\"fixed-case\">ADVANCE<\/jats:styled-content>) trial who were randomized to intensive glucose control or standard glucose control and followed up for a median of 5\u2009years were categorized into two groups: effective glycaemic control [haemoglobin A1c (<jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content>)\u2009\u2264\u20097.0% or a proportionate reduction in <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> over 10%] or ineffective glycaemic control (<jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content>\u2009&gt;\u20097.0% and a proportionate reduction in <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> less than or equal to 10%). Therapeutic intensification was defined as addition of an oral glucose\u2010lowering agent or commencement of insulin. Pooled logistic regression models examined the associations between patient factors, intensification and effective glycaemic control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 7768 patients (69.7%), including 3198 in the standard treatment group achieved effective glycaemic control. Compared to patients with ineffective control, patients with effective glycaemic control had shorter duration of diabetes and lower <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> at baseline and at the time of treatment intensification. Treatment intensification with addition of an oral agent or commencement of insulin was associated with a 107% [odds ratio, <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 2.07 (95% confidence interval, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.95\u20132.20)] and 152% [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>: 2.52 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 2.30\u20132.77)] greater chance of achieving effective glycaemic control, respectively. These associations were robust after adjustment for several baseline characteristics and not modified by the number of oral medications taken at the time of treatment intensification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Effective glycaemic control was associated with treatment intensification at lower <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> levels at all stages of the disease course and in both arms of the <jats:styled-content style=\"fixed-case\">ADVANCE<\/jats:styled-content> trial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dom.12238","type":"journal-article","created":{"date-parts":[[2013,11,19]],"date-time":"2013-11-19T09:49:04Z","timestamp":1384854544000},"page":"426-432","source":"Crossref","is-referenced-by-count":16,"title":["Intensification of medication and glycaemic control among patients with type 2 diabetes\u00a0\u2013\u00a0the <scp>ADVANCE<\/scp> trial"],"prefix":"10.1111","volume":"16","author":[{"given":"S.","family":"van Dieren","sequence":"first","affiliation":[{"name":"The George Institute for Global Health University of Sydney Sydney Australia"},{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. P.","family":"Kengne","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health University of Sydney Sydney Australia"},{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht the Netherlands"},{"name":"Department of medicine, South African Medical Research Council &amp; University of Cape Town Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Chalmers","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health University of Sydney Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. W. J.","family":"Beulens","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. M. E.","family":"Davis","sequence":"additional","affiliation":[{"name":"School of Medicine and Pharmacology, Fremantle Hospital University of Western Australia Fremantle Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Fulcher","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Endocrinology and Metabolism Royal North Shore Hospital Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. R.","family":"Heller","sequence":"additional","affiliation":[{"name":"Academic Unit of Diabetes, Endocrinology and Metabolism, School of Medicine and Biomedical Sciences Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Patel","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health University of Sydney Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Colagiuri","sequence":"additional","affiliation":[{"name":"Boden Institute for Obesity, Nutrition and Exercise Sydney University Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Hamet","sequence":"additional","affiliation":[{"name":"Research Centre Centre hospitalier del'Universit\u00e9 de Montr\u00e9al Montreal Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Mancia","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Marre","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Nutrition, H\u00f4pital Bichat\u2010Claude Bernard and Universit\u00e9 Paris 7 Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Neal","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health University of Sydney Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Williams","sequence":"additional","affiliation":[{"name":"School of Medicine University of Leicester Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. 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