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The gap between guidelines and reality: Type 2 diabetes in a national diabetes register 1996-2003

Eliasson, B; Cederholm, J; Nilsson, Peter LU and Gudbjornsdottir, S (2005) In Diabetic Medicine 22(10). p.1420-1426
Abstract
Guidelines for the treatment of risk factors in diabetes care have been updated recently, due to indisputable results from clinical end-point trials. This study evaluates risk factor control compared with current national and international targets during the period 1996-2003 in Type 2 diabetes (DM2). Patients were registered in primary-care and hospital outpatient clinics using computer software, or via the Internet. The clinical characteristics of the patients, treatment, HbA(1c), and risk factors were reported after screening by local methods. The numbers of cases of DM2 reported were 17547 in 1996 and 57119 in 2003. The mean HbA(1c) decreased from 7.8 to 7.2%, while blood pressure decreased from 150/82 to 143/78 mmHg during the same... (More)
Guidelines for the treatment of risk factors in diabetes care have been updated recently, due to indisputable results from clinical end-point trials. This study evaluates risk factor control compared with current national and international targets during the period 1996-2003 in Type 2 diabetes (DM2). Patients were registered in primary-care and hospital outpatient clinics using computer software, or via the Internet. The clinical characteristics of the patients, treatment, HbA(1c), and risk factors were reported after screening by local methods. The numbers of cases of DM2 reported were 17547 in 1996 and 57119 in 2003. The mean HbA(1c) decreased from 7.8 to 7.2%, while blood pressure decreased from 150/82 to 143/78 mmHg during the same period. Longitudinal analysis of results was performed in 5356 patients repeatedly reported, showing slightly lower effects. The new European treatment targets of HbA(1c) <= 6.1%, blood pressure < 130/80 mmHg and total cholesterol < 4.5 mmol/l were attained by 16, 13 and 28% of the patients in 2003, respectively. The prevalence of the metabolic syndrome in 2003 was 77%. Aspirin was prescribed in 36% of cases. Lipid-lowering, anti-hypertensive drugs, and treatment with oral hypoglycaemic agents in combination with insulin were increasingly employed during the period studied. Risk factor control in DM2 reported to the National Diabetes Register (NDR) is slowly improving, although multiple risk factors and the metabolic syndrome are found in most patients. The majority of subjects do not achieve current target levels for HbA(1c), blood pressure and blood lipids. Thus, giving up smoking and increased use of aspirin are called for, as well as more aggressive treatment of hyperglycaemia, elevated blood pressure and blood lipid levels, in accordance with updated international guidelines. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
diabetes, epidemiology, risk factor, registry
in
Diabetic Medicine
volume
22
issue
10
pages
1420 - 1426
publisher
Wiley-Blackwell
external identifiers
  • pmid:16176206
  • wos:000232304100022
  • scopus:25844431627
ISSN
1464-5491
language
English
LU publication?
yes
id
d5bd0aa1-8166-4973-9b17-62ca3fa96b3e (old id 891523)
date added to LUP
2008-01-11 15:18:17
date last changed
2017-01-01 07:06:41
@article{d5bd0aa1-8166-4973-9b17-62ca3fa96b3e,
  abstract     = {Guidelines for the treatment of risk factors in diabetes care have been updated recently, due to indisputable results from clinical end-point trials. This study evaluates risk factor control compared with current national and international targets during the period 1996-2003 in Type 2 diabetes (DM2). Patients were registered in primary-care and hospital outpatient clinics using computer software, or via the Internet. The clinical characteristics of the patients, treatment, HbA(1c), and risk factors were reported after screening by local methods. The numbers of cases of DM2 reported were 17547 in 1996 and 57119 in 2003. The mean HbA(1c) decreased from 7.8 to 7.2%, while blood pressure decreased from 150/82 to 143/78 mmHg during the same period. Longitudinal analysis of results was performed in 5356 patients repeatedly reported, showing slightly lower effects. The new European treatment targets of HbA(1c) &lt;= 6.1%, blood pressure &lt; 130/80 mmHg and total cholesterol &lt; 4.5 mmol/l were attained by 16, 13 and 28% of the patients in 2003, respectively. The prevalence of the metabolic syndrome in 2003 was 77%. Aspirin was prescribed in 36% of cases. Lipid-lowering, anti-hypertensive drugs, and treatment with oral hypoglycaemic agents in combination with insulin were increasingly employed during the period studied. Risk factor control in DM2 reported to the National Diabetes Register (NDR) is slowly improving, although multiple risk factors and the metabolic syndrome are found in most patients. The majority of subjects do not achieve current target levels for HbA(1c), blood pressure and blood lipids. Thus, giving up smoking and increased use of aspirin are called for, as well as more aggressive treatment of hyperglycaemia, elevated blood pressure and blood lipid levels, in accordance with updated international guidelines.},
  author       = {Eliasson, B and Cederholm, J and Nilsson, Peter and Gudbjornsdottir, S},
  issn         = {1464-5491},
  keyword      = {diabetes,epidemiology,risk factor,registry},
  language     = {eng},
  number       = {10},
  pages        = {1420--1426},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {The gap between guidelines and reality: Type 2 diabetes in a national diabetes register 1996-2003},
  volume       = {22},
  year         = {2005},
}