Diseases
Real-World Pharmacological Patterns and Residual Cardiometabolic Risk in Patients with Type 2 Diabetes in Romania
By Petca BL, Popovici PA, Igna AD and 2 others.
Abstract
Background
Contemporary management of type 2 diabetes mellitus (T2DM) has shifted from a glucose-centered approach toward integrated cardio-renal-metabolic protection. Although sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and intensive lipid-lowering therapies have demonstrated substantial cardiovascular and renal benefits, implementation in routine outpatient care and the burden of persistent residual risk remain insufficiently characterized in Romania.
Objectives
We aimed to evaluate routine-care pharmacological treatment patterns, identify residual cardio-renal-metabolic risk despite ongoing therapy, determine independent correlates of persistent adverse outcomes, and explore potential therapeutic gaps in adults with T2DM.
Methods
This cross-sectional observational study included 232 unique adults with T2DM attending a specialized outpatient diabetes clinic in Romania between 1 October 2024 and 19 February 2026. One eligible outpatient record per participant was analyzed; when multiple records were available, the earliest eligible record in the exported dataset was used as the index visit. No a priori sample-size calculation was performed. Pharmacological therapies, cardiovascular and renal phenotypes, metabolic biomarkers, and clinical outcomes were extracted from routinely collected electronic medical records. Residual risk was evaluated using glycemic, lipid, renal, obesity, and blood-pressure targets. Multivariable logistic regression analyses identified independent correlates of persistent cardio-metabolic abnormalities. An exploratory cumulative residual-risk count was constructed by summing seven clinically relevant uncontrolled risk factors.