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Introduction
The results of the DCCT and UK Prospective Study studies have shown that achieving the recommended glycemic targets reduces the morbidity in patients with diabetes mellitus (DM) [1, 2–3]. Uncontrolled diabetes mellitus is also associated with worsening quality of life [4, 5–6].
The diabetic medical standards defined by the American Diabetes Federation recommend a reduction in HbA1c < 7% (< 53 mmol/mol), which in most patients will lead to a decrease in the incidence of microvascular complications. In some patients, especially those with short-term diabetes, long life expectancy, and no cardiovascular disease, more stringent treatment goals, such as < 6.5%, can be proposed if these can be achieved without hypoglycemia or other adverse treatment consequences. Conversely, higher than recommended HbA1c values, e.g., < 8.0% or even slightly higher, may be tolerated on an individual basis in patients with a history of severe hypoglycemia, advanced micro- and macrovascular complications, low expected survival periods, or where better results cannot be achieved despite maximum care including extensive education, sufficient self-monitoring of glycemia, and use of combined treatment with available preparations, including insulin [7]. These recommendations are also supported in the case of type 2 diabetes mellitus by the consensual views of the European Association for the Study of Diabetes and the American Diabetes Association [8].
However, despite the continuously improving treatment options, many patients still do not achieve the recommended treatment goals. The results of the recently published multinational cross-sectional study, carried out in seven countries of the European Union and Turkey between 2009 and 2010 in patients with type 2 diabetes mellitus (T2DM), showed the mean (SD) HbA1c of the total patient population was 6.9% (± 1.1%) and 37.4% of patients had HbA1c ≥ 7%. The proportion of patients with HbA1c ≥ 7% ranged from 25.9% in The Netherlands to 36.3% in Germany to 52.0% in Turkey [9].
The only published cross-sectional multinational study published to date from the Central and Eastern European region, carried out between 2006 and 2007, showed that only a minority of diabetic patients [13.1% for type 1 diabetes (T1DM) and 21.4% for type 2 diabetes mellitus] had reached the then defined treatment goals (HbA1c < 6.5%), with an average attained HbA1c value of 8.2% for T1DM and 7.7% for T2DM [10]. However, neither of the above-mentioned studies investigated the extent to which treatment targets were...