Die Behandlungsqualität von Patienten mit Typ-1- und Typ-2-Diabetes mellitus in der hausärztlichen Betreuung: Ergebnisse einer vergleichenden Untersuchung in Ostvorpommern und Thüringen

Abstract

Up to the present moment there has been a large controversy over the metabolic control in patients with type-1 and type-2 diabetes mellitus receiving ambulatory treatment from general practitioners. Hence this trial aimed to assess the parameters of treatment quality in patients under ambulatory care in two German regions. A total of 2,242 patients from 25 general practitioners' care units were assessed from October 1998 to September 1999. The mean age of the patients was 67.5 +/- 13.1, and the mean diabetes duration was 8.8 +/- 7.5 years. 26.1% of the patients were treated without using anti-diabetic drugs, and 44.2% took oral anti-diabetic medications. 20.0% received insulin alone and 9.5% a combination therapy of insulin and oral anti-diabetic agents. The mean HbA1c of 6.9 +/- 1.5 was comparable in Thuringia and West Pomerania. It was measured in 68.4% of the patients. Blood pressure values were documented in 98.8%. A total of 31.6% of patients took part in structured diabetes treatment and teaching programmes. In Thuringia the percentage of patients under specialized diabetes care was 3.6%; in West Pomerania it was significantly lower (18%, p<0.001). The quality of treatment and metabolic control in patients with type-1- and type-2 diabetes mellitus receiving ambulatory care from general practitioners is much better than is commonly assumed. However, as indicated by the relatively low frequency of HbA1c measurements, the treatment quality is far from reaching the requirements of national guideline recommendations.