Improvement in Quality of Care for Patients with Type 2 Diabetes in Hungary Between 2008 and 2016: Results from Two Population-Based Representative Surveys.

Abstract

IntroductionDue to the increasing trends of recent decades, diabetes prevalence has reached a frequency of 1/11 adults worldwide. However, this disadvantageous trend has not been accompanied by worsened outcome indicators; better short-term (e.g., HbA1c levels) and long-term [e.g., all-cause mortality among type 2 diabetes mellitus (T2DM) patients] outcomes can be observed globally. We aimed to describe changes in the effectiveness of type 2 diabetes mellitus care between 2008 and 2016 based on outcome indicators.MethodsThe study is a secondary analysis of data from two previously performed surveys. Both surveys were conducted in the framework of the General Practitioners’ Morbidity Sentinel Stations Program (GPMSSP), which maintains a nationally representative registry of T2DM patients.ResultsThe largest improvement was observed in achieving fasting blood glucose and HbA1c target values [OR = 0.67, 95% confidence interval (CI), 0.56–0.80 and OR = 0.58; 95% CI, 0.48–0.70, respectively]. Moderate improvement was detected by reaching body mass index (BMI), diastolic blood pressure and total cholesterol target values (OR = 0.78, 95% CI, 0.65–0.93; OR = 0.78, 95% CI, 0.65–0.94 and OR = 0.76, 95% CI, 0.63–0.92, respectively).ConclusionOur study demonstrated that if standardized indicators are investigated in population-based samples, the effectiveness of T2DM care can be monitored by ad hoc surveys. The systematic application of this approach completed with the detailed documentation of the applied therapies could demonstrate the public health impact of certain modifications in T2DM care. An overall improvement in metabolic control (glycaemic control, lipid status and obesity) was observed, which was not accompanied by improved therapeutic target achievement for systolic blood pressure.