Medical care of type 2 diabetes mellitus in light of international and national recommendations: a retrospective analysis.

Abstract:

QUESTION UNDER STUDY:Type 2 diabetes mellitus (T2Dm) is a chronic disease with great economic impact. In 2009, the Swiss Society for Endocrinology and Diabetes (SSED) published recommendations for treatment of T2Dm. In Switzerland, few data are currently available on metabolic control and physician compliance with treatment guidelines. We aimed to investigate clinical care in T2Dm in the year after the publication of SSED recommendations. METHODS:We retrospectively studied the charts of all patients with T2Dm admitted to our general internal medicine clinic during 2009. Metabolic control was judged from glycated haemoglobin A1c (HbA1c) levels. Antidiabetic therapy was analysed, and frequencies of screening for end-organ damage were investigated. A group with newly diagnosed T2Dm was analysed separately from patients with known T2Dm upon admission. RESULTS:In patients with known T2Dm, the mean (± standard deviation) HbA1c level was 7.66% ± 1.73%. Only 44% of patients showed HbA1c levels at the target of ≤7%. Prior to admission and at discharge, 56% and 55% of patients, respectively, were treated with metformin. Among patients with HbA1c >8.5%, the proportion of those treated with insulin increased from 49% upon admission to 76% at discharge. Only half the patients received a lifestyle intervention in the year prior to admission or during hospital stay. Screening for diabetic retinopathy and nephropathy was performed in approximately one-third and two-thirds of patients, respectively. CONCLUSIONS:In the majority of unselected T2Dm patients admitted to our hospital, metabolic control was suboptimal. Implementation of treatment recommendations by both general practitioners and hospitals should be improved.

journal_name

Swiss Med Wkly

journal_title

Swiss medical weekly

authors

Burgmann K,Fatio S,Jordi B,Rutishauser J

doi

10.4414/smw.2013.13871

subject

Has Abstract

pub_date

2013-10-25 00:00:00

pages

w13871

eissn

1424-7860

issn

1424-3997

pii

smw-13871

journal_volume

143

pub_type

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