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The National Diabetes Register in Sweden: An implementation of the St. Vincent Declaration for Quality Improvement in Diabetes Care.

Gudbjörnsdottir, Soffia; Cederholm, Jan; Nilsson, Peter LU and Eliasson, Björn (2003) In Diabetes Care 26(4). p.1270-1276
Abstract
OBJECTIVE—To monitor glycemic control, treatable risk factors, and treatment profile for quality assessment of diabetes care on a national scale.



RESEARCH DESIGN AND METHODS—Four samples of 23,546, 32,903, 30,311, and 29,769 patients with diabetes (1996–1999) were studied based on a repeated national screening and quality assessment of diabetes care by the National Diabetes Register, Sweden, with participation of both hospitals and primary health care. Clinical characteristics included were age, sex, diabetes duration and treatment, glycemic control (HbA1c), office blood pressure (BP), BMI, smoking habits, and use of lipid-lowering drugs in patients with type 1 or type 2 diabetes.



RESULTS—Favorable... (More)
OBJECTIVE—To monitor glycemic control, treatable risk factors, and treatment profile for quality assessment of diabetes care on a national scale.



RESEARCH DESIGN AND METHODS—Four samples of 23,546, 32,903, 30,311, and 29,769 patients with diabetes (1996–1999) were studied based on a repeated national screening and quality assessment of diabetes care by the National Diabetes Register, Sweden, with participation of both hospitals and primary health care. Clinical characteristics included were age, sex, diabetes duration and treatment, glycemic control (HbA1c), office blood pressure (BP), BMI, smoking habits, and use of lipid-lowering drugs in patients with type 1 or type 2 diabetes.



RESULTS—Favorable decreases of mean HbA1c and BP values were registered during the 4-year study period for both type 1 (HbA1c 7.5–7.3% and BP 130/75–130/74 mmHg) and type 2 diabetic patients (HbA1c 7.0–6.7% and BP 151/82–147/80 mmHg). Treatment aims of HbA1c and BP levels were also achieved in increasing proportions for type 1 (HbA1c <7.5%: 50–58% and BP ≤140/85 mmHg: 77–79%), and type 2 diabetic patients (HbA1c <7.5%: 66–73% and BP ≤140/85 mmHg: 32–42%). The use of lipid-lowering drugs increased for type 1 (4–11%) and type 2 diabetic patients (10–22%). In type 2 diabetic patients, treatment with oral agents alone decreased, but combination therapy (insulin and oral agents) increased during the study period. Mean BMI increased during 1996–1999 in type 2 diabetic patients. High HbA1c and BP values in 1999 were predicted by high BMI values 1996 and by high increase of BMI during the period, independent of diabetes duration, age, and sex.



CONCLUSIONS—Decreasing mean HbA1c and BP levels and the wider use of lipid-lowering drugs during the late 1990s in patients with diabetes in a national sample from Sweden should translate into clinical benefits regarding micro- and macrovascular complications as well as diabetes-related mortality. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetes Care
volume
26
issue
4
pages
1270 - 1276
publisher
American Diabetes Association
external identifiers
  • wos:000185505300051
  • pmid:12663609
  • scopus:0041666540
ISSN
1935-5548
DOI
10.2337/diacare.26.4.1270
language
English
LU publication?
yes
id
b79d5440-da38-4501-b648-41d49bfa262b (old id 114277)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12663609&dopt=Abstract
date added to LUP
2007-07-23 11:05:40
date last changed
2018-10-03 09:31:24
@article{b79d5440-da38-4501-b648-41d49bfa262b,
  abstract     = {OBJECTIVE—To monitor glycemic control, treatable risk factors, and treatment profile for quality assessment of diabetes care on a national scale.<br/><br>
<br/><br>
RESEARCH DESIGN AND METHODS—Four samples of 23,546, 32,903, 30,311, and 29,769 patients with diabetes (1996–1999) were studied based on a repeated national screening and quality assessment of diabetes care by the National Diabetes Register, Sweden, with participation of both hospitals and primary health care. Clinical characteristics included were age, sex, diabetes duration and treatment, glycemic control (HbA1c), office blood pressure (BP), BMI, smoking habits, and use of lipid-lowering drugs in patients with type 1 or type 2 diabetes.<br/><br>
<br/><br>
RESULTS—Favorable decreases of mean HbA1c and BP values were registered during the 4-year study period for both type 1 (HbA1c 7.5–7.3% and BP 130/75–130/74 mmHg) and type 2 diabetic patients (HbA1c 7.0–6.7% and BP 151/82–147/80 mmHg). Treatment aims of HbA1c and BP levels were also achieved in increasing proportions for type 1 (HbA1c &lt;7.5%: 50–58% and BP ≤140/85 mmHg: 77–79%), and type 2 diabetic patients (HbA1c &lt;7.5%: 66–73% and BP ≤140/85 mmHg: 32–42%). The use of lipid-lowering drugs increased for type 1 (4–11%) and type 2 diabetic patients (10–22%). In type 2 diabetic patients, treatment with oral agents alone decreased, but combination therapy (insulin and oral agents) increased during the study period. Mean BMI increased during 1996–1999 in type 2 diabetic patients. High HbA1c and BP values in 1999 were predicted by high BMI values 1996 and by high increase of BMI during the period, independent of diabetes duration, age, and sex.<br/><br>
<br/><br>
CONCLUSIONS—Decreasing mean HbA1c and BP levels and the wider use of lipid-lowering drugs during the late 1990s in patients with diabetes in a national sample from Sweden should translate into clinical benefits regarding micro- and macrovascular complications as well as diabetes-related mortality.},
  author       = {Gudbjörnsdottir, Soffia and Cederholm, Jan and Nilsson, Peter and Eliasson, Björn},
  issn         = {1935-5548},
  language     = {eng},
  number       = {4},
  pages        = {1270--1276},
  publisher    = {American Diabetes Association},
  series       = {Diabetes Care},
  title        = {The National Diabetes Register in Sweden: An implementation of the St. Vincent Declaration for Quality Improvement in Diabetes Care.},
  url          = {http://dx.doi.org/10.2337/diacare.26.4.1270},
  volume       = {26},
  year         = {2003},
}