Population-based audit of non-insulin-dependent diabetic patients aged under 65 years in primary health care

Abstract

Objective - To audit treatment of non-insulin-dependent diabetes mellitus (NIDDM). Design - Cross-sectional, descriptive, population-based study. Setting - Primary health care. Subjects - NIDDM patients aged under 65 years in Mikkeli District, in eastern Finland. Results - Of 381 (220 men) eligible NIDDM patients, 260 (141 men) participated (68%). Of subjects with at least two fasting blood glucose values 6.7 mmol/l, diabetes diagnosis had been set to 63%. Eighty seven per cent had been annually checked up, and 36% had a satisfactory (7.5%) glycosylated haemoglobin A1c. Retinopathy, neuropathy and occasional microalbuminuria were detected in 13, 59 and 32% of patients, respectively. Patient education had been given to 85% of patients by the diabetes nurse. Of the patients, 79% were satisfied with the quality of diabetes education and care. Main outcome measures - Diagnostics of hyperglycaemia, regularity and continuity of care, metabolic control, complications, patient education and satisfaction. Conclusions - The metabolic control was poor among NIDDM patients in the study area. The diagnostics, regularity of care and the treatment of hyperglycaemia should be improved. Nevertheless, most patients were satisfied with both diabetes care and patient education.