Measures

The information was collected on standardized case report forms (CRFs) about demographics, medical history, pharmacologic and lifestyle therapy, glycemic control and other therapeutic targets, blood glucose self-monitoring, access to diabetes education, access to specialized care, hospitalizations, and medical complications and work absenteeism, among other variables. CRFs contained the question “Is the patient at target?” at the end of the document, and physicians were instructed to answer this question based on personal opinion about the global status of control of their patients. The possible standardized answers to this question were “yes”, “no”, and “unknown”. This question was not addressed immediately after the section of hemoglobin A1c (HbA1c) and other biochemical measurements in order to avoid perception bias toward a specific metabolic profile. Nevertheless, each investigator filled the CRFs completely, including the laboratory results and the qualitative questions. For the present analysis, our hypothesis was that physicians often overestimate the frequency of the patients at therapeutic target. We regarded HbA1c as pivotal for considering a patient at target, in such a way that if a patient had HbA1c ≥7%, he/she should not be considered under optimal control, even if blood pressure, lipids, body weight, and other variables were at target.