2393-PUB: First Metabolic Control Results in Insulin-Treated Diabetes Patients from Republic of Macedonia Derived from National eHealth System

Abstract

Republic of Macedonia (RoM) is estimated to have third highest diabetes prevalence in Europe. National eHealth System (NeHS) was introduced since 2015, enabling physicians to optionally record metabolic parameters. Our aim was to evaluate national metabolic control in insulin-treated pts, based on data derived from NeHS. NeHS was searched for all insulin-treated pts, as of 01-May-2017, with data in their Electronic Healthcare Records (EHR) for any of following parameters: HbA1c, BMI, Total Cholesterol (TC), LDL Cholesterol (LDL), Triglycerides (TG), Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP). Mean values were calculated and number of pts identified to pre-specified thresholds: HbA1c - 7% and 8%; BMI - 25 kg/m2 and 30 kg/m2; TC - 5 mmol/l; LDL - 2.6 mmol/l; TG - 1.7 mmol/l; SBP - 140 mmHg and DBP - 90 mmHg. Total number of insulin-treated pts in RoM was 37,011 out of 84,568 diagnosed pts (43.8%). Of those, 6.204 (16.8%), mean age 63.8 ± 11.7 years, 54.7% women, were identified as having data in EHR for any metabolic parameter. Mean HbA1c was 7.8 ± 1.8% (n=6,204); 2,346 pts (37.8%) ≤ 7%, 1,607 (25.9%) >7% and ≤ 8%; and 2,251 (36.3%) >8%. Mean BMI was 30.4 ± 5.2 kg/m2 (n=1,920); 273 pts (14.2%) ≤ 25 kg/m2, 739 (38.5%) >25 and ≤ 30 kg/m2, and 908 (47.3%) >30 kg/m2. Mean TC was 5.3 ± 1.4 mmol/l (n=1,838); 988 pts (53.8%) >5 mmol/l. Mean LDL was 3.2 ± 1.1 mmol/l (n=433); 290 pts (67.0%) >2.6 mmol/l. Mean TG was 2.3 ± 1.6 mmol/l (n=1,588); 938 pts (59.1%) >1.7 mmol/l. Mean SBP was 134.5 ± 17.3 mmHg (n=1,055); 232 pts (22.0%) >140 mmHg. Mean DBP was 81.1 ± 8.5 mmHg (n=1,055); 65 pts (6.2%) >90 mmHg. These are the first metabolic control results in insulin-treated pts from RoM, derived from NeHS. There is a need for improvement of glycemic control (36.3% of pts with HbA1c >8%), weight and lipid management. Since 16.8% of pts have any metabolic data in EHR, change from optional to mandatory recording is necessary to improve individual and national metabolic control. Disclosure I. Smokovski: Advisory Panel; Self; Sanofi. T. Milenkovic: None.